Respiratory Dead Space
Blood Gas Monitoring, Transcutaneous
Dimensional Measurement Accuracy
Respiratory Distress Syndrome, Adult
Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. (1/122)We have compared four tests for assessing airway sealing pressure with the laryngeal mask airway (LMA) to test the hypothesis that airway sealing pressure and inter-observer reliability differ between tests. We studied 80 paralysed, anaesthetized adult patients. Four different airway sealing pressure tests were performed in random order on each patient by two observers blinded to each other's measurements: test 1 involved detection of an audible noise; test 2 was detection of end-tidal carbon dioxide in the oral cavity; test 3 was observation of the aneroid manometer dial as the pressure increased to note the airway pressure at which the dial reached stability; and test 4 was detection of an audible noise by neck auscultation. Mean airway sealing pressure ranged from 19.5 to 21.3 cm H2O and intra-class correlation coefficient was 0.95-0.99. Inter-observer reliability of all tests was classed as excellent. The manometric stability test had a higher mean airway sealing pressure (P < 0.0001) and better inter-observer reliability (P < 0.0001) compared with the three other tests. We conclude that for clinical purposes all four tests are excellent, but that the manometric stability test may be more appropriate for researchers comparing airway sealing pressures. (+info)
Volumetric capnography in patients with acute lung injury: effects of positive end-expiratory pressure. (2/122)The aim of the study was to analyse the effects of positive end-expiratory pressure (PEEP) on volumetric capnography and respiratory system mechanics in mechanically ventilated patients. Eight normal subjects (control group), nine patients with moderate acute lung injury (ALI group) and eight patients with acute respiratory distress syndrome (ARDS group) were studied. Respiratory system mechanics, alveolar ejection volume as a fraction of tidal volume (VAE/VT), phase III slopes of expired CO2 beyond VAE and Bohr's dead space (VD/VT(Bohr)) at different levels of PEEP were measured. No differences in respiratory system resistances were found between the ALI and ARDS groups. VD/VT(Bohr) and expired CO2 slope beyond VAE were higher in ALI patients (0.52+/-0.01 and 13.9+/-0.7 mmHg x L(-1), respectively) compared with control patients (0.46+/-0.01 and 7.7+/-0.4 mmHg x L(-1), p<0.01, respectively) and in ARDS patients (0.61+/-0.02 and 24.9+/-1.6 mmHg x L(-1), p<0.01, respectively) compared with ALI patients. VAE/VT differed similarly (0.6+/-0.01 in control group, 0.43+/-0.01 in ALI group and 0.31+/-0.01 in ARDS group, p<0.01). PEEP had no effect on VAE/VT, expired CO2 slope beyond VAE and VD/VT(Bohr) in any group. A significant correlation (p<0.01) was found between VAE/VT and expired CO2 slope beyond VAE and lung injury score at zero PEEP. Indices of volumetric capnography are affected by the severity of the lung injury, but are unmodified by the application of positive end-expiratory pressure. (+info)
Oxygenator exhaust capnography as an index of arterial carbon dioxide tension during cardiopulmonary bypass using a membrane oxygenator. (3/122)We have studied the relationship between the partial pressure of carbon dioxide in oxygenator exhaust gas (PECO2) and arterial carbon dioxide tension (PaCO2) during hypothermic cardiopulmonary bypass with non-pulsatile flow and a membrane oxygenator. A total of 172 paired measurements were made in 32 patients, 5 min after starting cardiopulmonary bypass and then at 15-min intervals. Additional measurements were made at 34 degrees C during rewarming. The degree of agreement between paired measurements (PaCO2 and PECO2) at each time was calculated. Mean difference (d) was 0.9 kPa (SD 0.99 kPa). Results were analysed further during stable hypothermia (n = 30, d = 1.88, SD = 0.69), rewarming at 34 degrees C (n = 22, d = 0, SD = 0.84), rewarming at normothermia (n = 48, d = 0.15, SD = 0.69) and with (n = 78, d = 0.62, SD = 0.99) or without (n = 91, d = 1.07, SD = 0.9) carbon dioxide being added to the oxygenator gas. The difference between the two measurements varied in relation to nasopharyngeal temperature if PaCO2 was not corrected for temperature (r2 = 0.343, P = < 0.001). However, if PaCO2 was corrected for temperature, the difference between PaCO2 and PECO2 was not related to temperature, and there was no relationship with either pump blood flow or oxygenator gas flow. We found that measurement of carbon dioxide partial pressure in exhaust gases from a membrane oxygenator during cardiopulmonary bypass was not a useful method for estimating PaCO2. (+info)
In vitro and in vivo assessment of the Ventrak 1550/Capnogard 1265 for single breath carbon dioxide analysis in neonates. (4/122)The Ventrak 1550/Capnogard 1265 (V&C) enables deadspace (VD) measurements to be made in neonates. The aim of our studies was to validate the V&C device for VD measurement in vitro (lung model) and in vivo (adult rabbits). Methods of measurement of VD using the V&C (automatic computation, interactive carbon dioxide-volume plot analysis, Bohr equation) were tested by comparing known added deadspace volumes (VDadd) with calculated VDadd. After producing a change in alveolar (VDalv) and physiological (VDphys) deadspace by in vivo broncho-alveolar lavage, VDalv and VDphys computed automatically were compared with values calculated by the Bohr-Enghoff equations. VDadd was slightly underestimated (absolute error in mean: automatically -0.61 ml; interactively -0.55 ml; Bohr -0.54 ml). The higher the VDadd, the lower the absolute errors and coefficients of variation (cv). The highest cv occurred for automatic analysis (approximately 11%) compared with < 6% for interactive analysis or the Bohr equation. Average differences between results calculated automatically and by the Bohr-Enghoff equation were -0.79 ml for VDalv (95% confidence interval -2.02 to 0.44 ml) and -0.23 ml for VDphys (-0.6 to 0.14 ml). We conclude that the V&C can be used in newborn infants undergoing mechanical ventilation, if changes in VD are < 5 ml, interactive analysis or the Bohr equation should be used. (+info)
Measurement of carbon dioxide production in very low birth weight babies. (5/122)BACKGROUND: CO2 production is most commonly measured by using indirect calorimetry to quantify elimination of CO(2) in breath (VCO2). An alternative is to measure the rate at which CO2 appears in the body pool (RaCO2) by infusing a (13)C labelled bicarbonate tracer. VCO2 and RaCO2 generally differ but are related by c, a factor that adjusts for the incomplete recovery of infused tracer in the breath. The literature relating to human studies cites a wide range of values for c but the only neonatal study to determine c empirically estimated a mean value of 0.77. AIM: To estimate fractional recovery rate, c, in very low birthweight babies, and assess the feasibility of using the isotopic technique to measure CO2 production during mechanical ventilation. METHOD: Eleven spontaneously breathing, continuously fed, very low birthweight infants (median birth weight 1060 g, median gestational age 29 weeks) were studied. RESULTS: Mean (SD) VCO2 was 9.0 (2.0) ml/min (standard temperature and pressure dry, STPD) and mean (SD) RaCO2 was 9.6 (2.1) ml/min (STPD). The mean (SD) value of c was estimated as 0.95 (0.13). The 95% confidence intervals of the mean were 0.87-1.03. CONCLUSIONS: The results emphasise the importance of measuring c for a given study population rather than assuming a value based on adult studies. The close approximation of RaCO2 and VCO2 in this group of babies implies that the labelled bicarbonate infusion technique could be used to measure simply CO2 production during mechanical ventilation. (+info)
Breath interval as a measure of dynamic opioid effect. (6/122)We measured breath interval to characterize the time course of opioid effect in anaesthetized patients breathing spontaneously during knee replacement surgery with concurrent regional nerve blockade. Breath interval was recorded before and after a single dose of fentanyl 0.75 microgram kg-1 i.v. Breath interval was measured between the start of successive inspirations, identified by a decrease in carbon dioxide concentration, sampled at the laryngeal mask connection. Nineteen patients were admitted to the study, of whom nine were withdrawn (there was a recording failure for one patient, five patients had inadequate block and three were excessively depressed by the fentanyl). Using MKMODEL software, the mean (SD) dynamic elimination half-life and dynamic mean brain residence time of fentanyl were 15.3 (7.8) and 24.1 (8.1) min, respectively. The times to detection of change from baseline, and peak effect of fentanyl on breath interval were 0.9 (0.6) and 5.2 (1.4) min, respectively. Breath interval increased from 2.9 (1.0) s to a maximum of 9.0 (5.7) s. There were no differences between the time course of changes in breath interval and end-tidal carbon dioxide concentrations. End-tidal carbon dioxide concentrations increased from a baseline of 6.6 (0.9)% to a peak of 8.2 (0.8)%. Breath interval was a useful and reproducible method of monitoring the duration of opioid effect in anaesthetized patients breathing spontaneously when surgical stimulation was not affecting the CNS. The data provide information on the duration of action of fentanyl and could guide dosage. (+info)
Arterial to end-tidal carbon dioxide pressure difference during laparoscopic surgery in pregnancy. (7/122)BACKGROUND: There is controversy about whether capnography is adequate to monitor pulmonary ventilation to reduce the risk of significant respiratory acidosis in pregnant patients undergoing laparoscopic surgery. In this prospective study, changes in arterial to end-tidal carbon dioxide pressure difference (PaCO2--PetCO2), induced by carbon dioxide pneumoperitoneum, were determined in pregnant patients undergoing laparoscopic cholecystectomy. METHODS: Eight pregnant women underwent general anesthesia at 17-30 weeks of gestation. Carbon dioxide pnueumoperitoneum was initiated after obtaining arterial blood for gas analysis. Pulmonary ventilation was adjusted to maintain PetCO2 around 32 mmHg during the procedure. Arterial blood gas analysis was performed during insufflation, after the termination of insufflation, after extubation, and in the postoperative period. RESULTS: The mean +/- SD for PaCO2--PetCO2 was 2.4 +/- 1.5 before carbon dioxide pneumoperitoneum, 2.6 +/- 1.2 during, and 1.9 +/- 1.4 mmHg after termination of pneumoperitoneum. PaCO2 and pH during pneumoperitoneum were 35 +/- 1.7 mmHg and 7.41 +/- 0.02, respectively. There were no significant differences in either mean PaCO2--PetCO2 or PaCO2 and pH during various phases of laparoscopy. CONCLUSIONS: Capnography is adequate to guide ventilation during laparoscopic surgery in pregnant patients. Respiratory acidosis did not occur when PetCO2 was maintained at 32 mmHg during carbon dioxide pneumoperitoneum. (+info)
Non-invasive respiratory monitoring in paediatric intensive care unit. (8/122)Monitoring respiratory function is important in a Paediatrics Intensive Care Unit (PICU), as majority of patients have cardio-respiratory problems. Non-invasive monitoring is convenient, accurate, and has minimal complications. Along with clinical monitoring, oxygen saturation using pulse oximetry, transcutaneous oxygenation (PtcO2) and transcutaneous PCO2 (PtcCO2) using transcutaneous monitors and end-tidal CO2 using capnography are important and routine measurements done in most PICUs. Considering the financial and maintenance constraints pulse oximetry with end tidal CO2 monitoring can be considered as most feasible. (+info)
There are several possible causes of hypoventilation, including:
1. Respiratory muscle weakness or paralysis: This can be due to a variety of conditions, such as muscular dystrophy, amyotrophic lateral sclerosis (ALS), or spinal cord injury.
2. Chronic respiratory failure: This can be caused by conditions such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, or pulmonary fibrosis.
3. Sleep apnea: Hypoventilation can occur during sleep due to the loss of muscle tone in the diaphragm and other respiratory muscles.
4. Anesthesia-induced hypoventilation: Some anesthetics can suppress the respiratory drive, leading to hypoventilation.
5. Drug overdose or intoxication: Certain drugs, such as opioids and benzodiazepines, can depress the central nervous system and lead to hypoventilation.
6. Trauma: Hypoventilation can occur in patients with severe injuries to the chest or abdomen that impair breathing.
7. Sepsis: Severe infections can cause hypoventilation by suppressing the respiratory drive.
8. Metabolic disorders: Certain metabolic disorders, such as diabetic ketoacidosis, can lead to hypoventilation.
Treatment of hypoventilation depends on the underlying cause and may include oxygen therapy, mechanical ventilation, and addressing any underlying conditions or complications. In some cases, hypoventilation may be a sign of a more severe condition that requires prompt medical attention to prevent further complications and improve outcomes.
There are several potential causes of hyperventilation, including anxiety, panic attacks, and certain medical conditions such as asthma or chronic obstructive pulmonary disease (COPD). Treatment for hyperventilation typically involves slowing down the breathing rate and restoring the body's natural balance of oxygen and carbon dioxide levels.
Some common signs and symptoms of hyperventilation include:
* Rapid breathing
* Deep breathing
* Dizziness or lightheadedness
* Chest pain or tightness
* Shortness of breath
* Confusion or disorientation
* Nausea or vomiting
If you suspect that someone is experiencing hyperventilation, it is important to seek medical attention immediately. Treatment may involve the following:
1. Oxygen therapy: Providing extra oxygen to help restore normal oxygen levels in the body.
2. Breathing exercises: Teaching the individual deep, slow breathing exercises to help regulate their breathing pattern.
3. Relaxation techniques: Encouraging the individual to relax and reduce stress, which can help slow down their breathing rate.
4. Medications: In severe cases, medications such as sedatives or anti-anxiety drugs may be prescribed to help calm the individual and regulate their breathing.
5. Ventilation support: In severe cases of hyperventilation, mechanical ventilation may be necessary to support the individual's breathing.
It is important to seek medical attention if you or someone you know is experiencing symptoms of hyperventilation, as it can lead to more serious complications such as respiratory failure or cardiac arrest if left untreated.
In adults, RDS is less common than in newborns but can still occur in certain situations. These include:
* Sepsis (a severe infection that can cause inflammation throughout the body)
* Pneumonia or other respiratory infections
* Injury to the lung tissue, such as from a car accident or smoke inhalation
* Burns that cover a large portion of the body
* Certain medications, such as those used to treat cancer or autoimmune disorders.
Symptoms of RDS in adults can include:
* Shortness of breath
* Rapid breathing
* Chest tightness or pain
* Low oxygen levels in the blood
* Blue-tinged skin (cyanosis)
* Confusion or disorientation
Diagnosis of RDS in adults is typically made based on a combination of physical examination, medical history, and diagnostic tests such as chest X-rays or blood gas analysis. Treatment may involve oxygen therapy, mechanical ventilation (a machine that helps the patient breathe), and medications to help increase surfactant production or reduce inflammation in the lungs. In severe cases, a lung transplant may be necessary.
Prevention of RDS in adults includes avoiding exposure to risk factors such as smoking and other pollutants, maintaining good overall health, and seeking prompt medical attention if any respiratory symptoms develop.
Emergency medical personnel in the United Kingdom
Carbon dioxide sensor
Gabor B. Racz
Emergency medical technician
UCLA Emergency Medical Services
Integrated pulmonary index
Index of infrared articles
Outline of anesthesia
Emergency medical services in Germany
List of MeSH codes (E01)
Paramedics in Germany
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Procedural sedation and analgesia2
- Quantitative waveform capnography is rapidly becoming a standard of care for any intubated patient. (emcrit.org)
- Waveform capnography is a fine monitoring technique used to measure and analyze the concentration of carbon dioxide (CO2) when a patient exhales. (neutechmedical.com)
- During waveform capnography, a small sample of exhaled breath is captured and analyzed for its CO2 content. (neutechmedical.com)
- Waveform capnography is widely used in a variety of clinical settings, including operating rooms, intensive care units (ICUs), emergency departments, and pre-hospital settings. (neutechmedical.com)
- In this CPD evening we will discuss both capnography and ventilation, before breaking off into small group practical sessions, working hands-on with a ventilator and a carbon dioxide-expiring canine model. (burtonsveterinary.com)
- This will enable the real-life simulation of a patient under anaesthesia and will focus on using capnography as a tool during mechanical ventilation. (burtonsveterinary.com)
- Capnography is the monitoring of the concentration or partial pressure of carbon dioxide in the respiratory gases. (neutechmedical.com)
- Capnography is the measurement of carbon dioxide in a patient's exhalation over time. (neutechmedical.com)
- A capnography monitor is a medical device used to measure and display the concentration of carbon dioxide (CO2) in a patient's breath in real time. (neutechmedical.com)
- Our OEM partners, their clinicians and patients benefit from the deep clinical validation and education, wide range of patient interfaces and applications, and the Smart Capnography™ clinical decision support tools of Microstream™ etCO 2 monitoring technology. (medtronic.com)
- Efficient and easy to use, Microstream™ capnography is engineered for use on both intubated and non-intubated patients, and can be used on virtually all patient populations, from neonate to adults, and in virtually all clinical environments. (medtronic.com)
- The patented Smart Capnography™ family of algorithms simplifies the use of capnography monitoring and/or was engineered to reduce alarms, and provide clinical workflow utility for improved patient safety. (medtronic.com)
- This rise in the market can be attributed to the development of portable/point-of-care capnography devices, clinical benefits of capnography equipment over pulse oximetry and the evolving guidelines related to the clinical use of capnography. (pharmiweb.com)
- Commonly used during anesthesia procedures, capnography is increasingly being used by paramedics in the field for a variety of purposes, including evaluating the success of resuscitation efforts, confirming clinical death, and causing respiratory distress. (neutechmedical.com)
- Recent surveys indicate that upwards of 90-95 percent agree that capnography is easy to understand and an important monitoring tool for patients with cardiac arrest who are experiencing respiratory distress, or sick with sepsis. (neutechmedical.com)
- Capnography monitors have a display screen that shows the capnogram waveform, which represents the change in CO2 concentration over time during the respiratory cycle. (neutechmedical.com)
- Capnography may be useful in the evaluation of children with potential respiratory compromise. (medscape.com)
- Pune, Maharashtra, India, June 29 2020 (Wiredrelease) Data Bridge Market Research - This large scale Capnography Equipment Market research report involves six major parameters namely market analysis, market definition, market segmentation, key developments in the market, competitive analysis, and research methodology. (pharmiweb.com)
- Capnography Equipment Market To 2026 Analysis By Applicat. (pharmiweb.com)
- Capnography Equipment Market report helps uncover the general market conditions and tendencies. (pharmiweb.com)
- The Capnography Equipment Market document assist businesses with the intelligent decision making and better manage marketing of goods which ultimately leads to growth in the business. (pharmiweb.com)
- Request an analyst call or drop down an enquiry to get thorough Capnography Equipment Market report. (pharmiweb.com)
- A world class Capnography Equipment report best suits the requirements of the client. (pharmiweb.com)
- The Global Capnography Equipment Market is expected to rise from its initial estimated value of USD 297.10 million in 2018 to an estimated value of USD 425.75 million by 2026 registering a CAGR of 4.6% in the forecast period of 2019-2026. (pharmiweb.com)
- The market is predicted to witness significant growth over the forecast period, owing to the growing consumer awareness about the benefits of Capnography Equipment. (pharmiweb.com)
- That was the motivation for redesigning the capnography sampling lines - without sacrificing the reliability and accuracy you've come to expect from Microstream™ technology. (philips.dk)
- Medtronic offers flexible etCO 2 OEM solutions that help leading OEM partners integrate the value, power and accuracy of Microstream™ capnography technology into the broadest range of multiparameter monitoring and medical device host systems. (medtronic.com)
- View cart "Porter Capnography Hood Adapters (25) & Punch" has been added to your cart. (salvin.com)
- It can be accomplished through various measurements, such as negative inspiratory force, vital capacity, blood gas analysis, or capnography. (medscape.com)
- The results of our analysis indicate that the use of capnography during GEP with procedural sedation is associated with significant reductions in the risk of pharmacological rescue events in outpatients and death in inpatients. (medscape.com)
- Despite the limitations of this retrospective data-based study, we believe the use of capnography during GEP performed with sedation should be recommended. (medscape.com)
- In anesthesia and procedural sedation, end-tidal capnography has become the standard of care. (medscape.com)
- 4. Efficacy of End-Tidal Capnography Monitoring during Flexible Bronchoscopy in Nonintubated Patients under Sedation: A Randomized Controlled Study. (nih.gov)
- 16. The value of capnography during sedation or sedation/analgesia in pediatric minor procedures. (nih.gov)
- A trained observer (who may also be the person giving the PSA drugs) is required to monitor the patient (sedation level, airway, ventilation, vital signs, pulse oximetry and/or capnography) throughout the sedation and recovery periods. (msdmanuals.com)
- [ 13 ] Capnography can also be used to ensure ventilation with supraglottic devices, as well as to confirm that a spontaneously ventilating patient is in fact breathing (eg, via face mask or nasal cannula sampling). (medscape.com)
- Therefore, capnography should be used with end-tidal volume measurements for a full assessment of ventilation parameters. (medscape.com)