No abstract available.
Capnography*

No abstract available.
Capnography* ; Humans

No abstract available.
Capnography ; Humans

Unidirectional valve malfunction causes re-breathing of expired gas during anesthesia. Capnography is a useful method for monitoring the integrity of anesthetic equipment such as the unidirectional valves in a circular system. We report, here a case in which the capnography did not sound any rebreathing alarm, but the capnogram showed a prolonged plateau, an apparently short inspiratory period and a gradually sloping descending limb that stopped just short of baseline. As a result, capnography helped to identify an inspiratory unidirectional valve malfunction during the course of anesthesia. This study emphasizes the need to analyze the capnogram during every procedure involving anesthesia, in addition to preoperative checking of the Unidirectional valve.
Anesthesia ; Capnography ; Extremities

Malfunction of the unidirectional valve in a breathing circuit system may cause hypercapnia from the rebreathing of expired gas, ventilation failure, and barotrauma. Capnography is a useful method for monitoring the integrity of the unidirectional valve. We experienced two cases of malfunction of a unidirectional valve which caused leakage and reverse flow, diagnosed early as a change of the capnographic waveform. One case was caused by expiratory unidirectional valve breakage. The other was caused by an incorrectly-assembled inspiratory unidirectional valve.
Barotrauma ; Capnography ; Hypercapnia ; Respiration ; Ventilation

With the rapid development of diagnostic and therapeutic procedures performed outside the operating room (OR), the need for appropriate sedation care has emerged in importance to ensure the safety and comfort of patients and clinicians. The preparation and administration of sedatives and sedation care outside the OR require careful attention, proper monitoring systems, and clinically useful sedation guidelines. This literature review addresses proper monitoring and selection of sedatives for diagnostic and interventional procedures outside the OR. As the depth of sedation increases, respiratory depression and cardiovascular suppression become serious, necessitating careful surveillance using appropriate monitoring equipment.
Capnography ; Dexmedetomidine ; Humans ; Hypnotics and Sedatives ; Operating Rooms ; Respiratory Insufficiency

BACKGROUND: Maintenance of adequate concentration of carbon dioxide during hypothermic cardiopulmonary bypass is important in order to improve tissue perfusion by maintaining vasodilatation. This study evaluated the usefulness of the analysis of gas sampled from the exhaust port of a membrane oxygenator in the estimation of carbon dioxide tension in arterial blood (PaCO2). METHODS: One hundred sixty four arterial blood gases were drawn from 45 adult and 30 pediatric cardiac surgical patients undergoing hypothermic cardiopulmonary bypass. Carbon dioxide tensions were measured in the membrane oxygenator exhaust gas (swept gas; PswCO2) using a capnography and in arterial blood using intermittent gas analysis. We compared the PswCO2 with temperature-uncorrected (alpha-stat) and -corrected (pH-stat) PaCO2 during cardiopulmoary bypass. RESULTS: The mean PaCO2 measured with alpha-stat and pH-stat, and PswCO2 obtained in adult patients during hypothermic cardiopulmonary bypass were 29.8 +/- 4.9, 19.5 +/- 4.1 and 22.3 +/- 4.2 mmHg, respectively. In pediatric patients, alpha-stat PaCO2, pH-stat PaCO2 and PswCO2 were 39.7 +/- 7.7, 24.7 +/- 6.2 and 20.3 +/- 6.0 mmHg, respectively. There was a significant positive correlation between PswCO2 and alpha-stat PaCO2 (adult patients: slope = 0.49, r = 0.64, P < 0.001; pediatric patients: slope = 0.53, r = 0.68, P < 0.001) and pH-stat PaCO2 (adult patients: slope = 0.85, r = 0.81, P < 0.001; pediatric patients: slope = 0.73, r = 0.73, P < 0.001). On comparison of subsequent measurements, 3.8% (adult patients) and 11.4% (pediatric patients) of changes in PaCO2 and PswCO2 were in opposite direction. CONCLUSIONS: Our results indicate that in adult and pediatric patients undergoing hypothermic cardiopulmonary bypass PswCO2 can be an indicator of changes in trend of PaCO2.
Adult ; Capnography ; Carbon Dioxide* ; Carbon* ; Cardiopulmonary Bypass* ; Gases ; Humans ; Oxygen* ; Oxygenators* ; Oxygenators, Membrane ; Perfusion ; Vasodilation

PURPOSE: The aim of this study was to assess the accuracy and timeliness of using tracheal ultrasound for examination of endotracheal tube placement in cardiac arrest patients. METHODS: This was a prospective, observational study, conducted at the emergency department of a university teaching hospital. Patients underwent emergency intubation due to cardiac arrest. Airway ultrasonography was performed during emergency intubation with the transducer placed transversely at the trachea over the suprasternal notch. Quantitative waveform capnography was used as the criterion standard for confirmation of tracheal intubation. The main outcome was the timeliness between airway ultrasonography and capnography. RESULTS: A total of 16 patients and 19 intubations were included in the analysis. The endotracheal tube was placed in the trachea in 16 intubations and in the esophagus in three intubations. The overall sensitivity and specificity of ultrasound for confirmation of tracheal intubation was 100%, respectively. The capnography application time after intubation was 17.5(10.0~32.5) seconds. The capnograpny confirmation time after application was 30(10~120) seconds. The ultrasound confirmation time for endotracheal tube placement after application was 5(4~5) seconds. CONCLUSION: When patients were in a low pulmonary blood flow state, such as cardiac arrest, capnography confirmation of endotracheal tube placement was not rapid and needed a lot of times. Ultrasound confirmation was very rapid and accurate, and was not affected by pulmonary blood flow. Ultrasound confirmation of endotracheal tube placement is more useful in the emergency department.
Capnography ; Emergencies ; Esophagus ; Heart Arrest ; Hospitals, Teaching ; Humans ; Intubation ; Prospective Studies ; Sensitivity and Specificity ; Trachea ; Transducers

A 33 year old female patient was scheduled for laser laryngomicrosurgery to remove a polyp arising from the posterior one third of the vocal cord.A double lumen central venous catheter was inserted through the cricothyroid membrane and transtracheal high frequency jet ventilation was performed via the distal lumen.The proximal lumen was connected to a capnography monitor, enabling breath by breath monitoring of PETCO2.The surgery was successfully completed, and the patient was discharged from the post anesthesia care unit (PACU) three hours after surgery without any complication.
Anesthesia ; Capnography ; Central Venous Catheters ; Female ; High-Frequency Jet Ventilation ; Humans ; Membranes ; Organothiophosphorus Compounds ; Polyps

BACKGROUND: The monitoring of end-tidal carbon dioxide tension (PETCO2) and oxygen supply may be required in spontaneously breathing patients during spinal anesthesia, particulary in cases involving high spinal block, underlying pulmonary disease, and use of a sedative drug. We investigated changes in PETCO2 and arterial oxygen tension versus oxygen flow rate via a nasal cannula, and the correlation between arterial carbon dioxide tension (PaCO2) and PETCO2 in spontaneously breathing patients during spinal anesthesia. METHODS: Thirty adult patients participated in this study. We performed spinal anesthesia with an optimal dose of heavy marcaine. After determining the sensory blockade level, PETCO2 was sampled from hub of a 14-gauge central catheter piercing one of the two nasal oxygen prongs, and oxygen flow rates (2, 3, 4 or 5 L/min) were measured by on-line capnography. The oxygen flow rates were varied every 5 minutes, and PETCO2 values and arterial samples for PaCO2 and arterial oxygen tension (PaO2) analysis were obtained at the end of each 5-minute period. RESULTS: No significant difference in PETCO2 was observed at the different oxygen flow rates. The results show that PETCO2 correlates closely with PaCO2 irrespective of oxygen flow rate. The PaO2 values were; 155.7 +/- 26.3, 192.7 +/- 36.6, 217.0 +/- 40.6 and 241.4 +/- 51.3 mmHg at nasal oxygen flow rates of 2, 3, 4 and 5 L/min, respectively. CONCLUSIONS: The measurement of PETCO2 via this nasal cannula was useful for continuous, noninvasive monitoring during spinal anesthesia irrespective of oxygen flow rate.
Adult ; Anesthesia, Spinal* ; Bupivacaine ; Capnography ; Carbon Dioxide ; Catheters* ; Humans ; Lung Diseases ; Oxygen* ; Respiration