Capnography device1/7/2024 ![]() ![]() doi:10.1056/NEJMoa0128355). Caregivers may utilize the PetCO2 waveform and V’CO2 to optimize lung recruitment, to validate optimal PEEP adjustments, and to identify issues with perfusion (systemic and pulmonary) ( Kallet RH, Alonso JA, Pittet JF, Matthay MA. Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome. 4, Nuckton TJ, Alonso JA, Kallet RH, et al. Prognostic value of the pulmonary dead-space fraction during the first 6 days of acute respiratory distress syndrome. An increasing VD/Vt ratio can represent a potential increase in mortality, based on the level of increase ( Kallet RH, Alonso JA, Pittet JF, Matthay MA. The dead space to tidal volume ratio (VD/Vt) is an important capnography measurement. In the intensive care unit, waveform capnography can continue monitoring of airway placement and patency, with various airway adjuncts. (2004). Capnography: Clinical Aspects. New York: Cambridge University Press.2). Obstructive lung diseases, pneumonia, neuromuscular disorders, and central nervous system disorders that result in impaired respiratory function will therefore effect a change in PetCO2 value ( Gravenstein, J., Jaffe, M., & Paulus, D. The removal of CO2 from the lungs to the environment is affected by changes in respiratory function. The transport of CO2 to the lungs relies on proper cardiovascular function therefore, any factor that alters cardiovascular function may also influence CO2 transport to the lungs ( Gravenstein, J., Jaffe, M., & Paulus, D. This lowers the production of CO2 and may lead to a decrease in PetCO2 if the minute ventilation does not increase at the same time ( Gravenstein, J., Jaffe, M., & Paulus, D. A decrease in metabolism occurs in patients who are hypothermic, or sedated and paralyzed. Fever, sepsis, pain, and seizures are all conditions that increase metabolism, causing a corresponding increase in CO2 production and, in turn, an increase in PetCO2. If both circulation and ventilation are stable - a state which can only be achieved in passive mechanically ventilated patients - CO2 monitoring can be used as an indicator of CO2 production. Capnography provides a graphical representation of expired CO2 and serves as a noninvasive means of displaying real-time information about the CO2 kinetics in mechanically ventilated patients.Īn increase or decrease in the patient's metabolic rate will lead to a change in CO2 production and, therefore, CO2 elimination as well. Clinical use of volumetric capnography in mechanically ventilated patients. For the elimination of CO2, there is a close, continuous balance between the production of CO2 in the tissues, its transport in the blood, diffusion into the alveoli, and elimination by ventilation ( Kremeier P, Böhm SH, Tusman G. There are many factors that may affect the amount of carbon dioxide in the end-tidal gas (PetCO2). ![]()
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