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: 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

PURPOSE: The purpose of this study was to determine whether continuous capnography monitoring detects adverse respiratory and airway events earlier than pulse oximetry and the clinical exam can during intramuscular ketamine for procedural sedation in children. METHODS: This study was a prospective observational study conducted from April 2009 to March 2010 in an urban Korean teaching hospital. Pediatric patients who needed procedural sedation for primary closure were enrolled. After patients received intramuscular ketamine, they were monitored using clinical ventilation assessment, pulse oximetry and capnography. Adverse respiratory and airway events were recorded RESULTS: A total of 91 patients were enrolled. Of the 91 patients, 16 (17%) had adverse respiratory events; 5 had hypoxia. Capnography was 100% sensitive for predicting hypoxia and apnea. CONCLUSION: When intramuscular ketamine is administered for procedural sedation in children, capnography allows early detection of adverse respiratory events.
Anoxia ; Apnea ; Capnography ; Child ; Conscious Sedation ; Hospitals, Teaching ; Humans ; Ketamine ; Oximetry ; Prospective Studies ; Ventilation

BACKGROUND: During craniotomy operations, the PaCO2 has therapeutic implications because hyperventilation is often used to lower intracranial pressure. PETCO2 is often used as an estimate of PaCO2, with the assumption that P(a-ET)CO2 is relatively constant. To clarify the relationship between PaCO2 and PETCO2, sixty patients undergoing elective craniotomies were studied. METHODS: Arterial blood gases were measured from 30 minutes after endotracheal intubation to skin closure at an interval of 30 minutes in thirty patients, and at random interval in another thirty patients. PETCO2 was simultaneously determined with infrared capnography(Datex AS/3TM, Filand). RESULTS: The PaCO2 was 31.7+/-3.0 mmHg and PETCO2, 26.3+/-2.5 mmHg, with a P(a-ET)CO2 of 5.5+/-2.7 mmHg(n = 431, range between 0-13.5). There was a significant positive correlation between PaCO2 and PETCO2(r = 0.537, slope = 0.440, P<0.001) and between P(a-ET)CO2 and PaCO2(r = 0.625, slope = 0.555, P<0.001). Although changes in the pooled data of PaCO2 and PETCO2 correlated statistically, comparisons in 43 of 60(71.6%) individuals were not correlated. On comparisons of subsequent measurements, 17.0% of changes in PaCO2 and PETCO2 were in opposite directions. P(a-ET)CO2 had a tendency to increase with time during surgery(slope = 0.0082), but there was no statistically significant difference between the measurements. CONCLUSION: The PETCO2 measured with infrared capnography does not provide a stable reflection of PaCO2 in many patients undergoing craniotomy. Therefore, we concluded that capnography must be used in conjuction with arterial blood gas measurements for monitoring the respiratory acid-base status of mechanically ventilated neurosurgical patients undergoing craniotomy.
Capnography ; Carbon Dioxide* ; Carbon* ; Craniotomy* ; Gases ; Humans ; Hyperventilation ; Intracranial Pressure ; Intubation, Intratracheal ; Skin

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