Clinical Pediatric Emergency Medicine
Volume 10, Issue 2 , Pages 82-89 , June 2009

Capnographic Monitoring in Respiratory Emergencies

  • Joshua Nagler, MD

      Affiliations

    • Corresponding Author InformationReprint requests and correspondence: Joshua Nagler, MD, Division of Emergency Medicine, Children's Hospital Boston, Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115.
  • ,
  • Baruch Krauss, MD, EdM

References 

  1. Smalhout B, Kalenda Z. An atlas of capnography. The Netherlands: Kerckebosche Zeist; 1975;
  2. Swedlow DB. Capnometry and capnography: the anesthesia disaster early warning system. SemAnesth. 1986;5:194–205
  3. Kalenda Z. Mastering infrared capnography. The Netherlands: Kerckebusch Zeist; 1989;
  4. Berengo A, Cutillo A. Single-breath analysis of carbon dioxide concentration records. J Appl Physiol. 1961;16:522–530
  5. Hoffbrand BI. The expiratory capnogram: a measure of ventilation-perfusion inequalities. Thorax. 1966;21:518–523
  6. Yamanaka MK, Sue DY. Comparison of arterial-end-tidal Pco2 difference and dead space/tidal volume ratio in respiratory failure. Chest. 1987;92:832–835
  7. Hardman JG, Aitkenhead AR. Estimating alveolar dead space from the arterial to end-tidal CO(2) gradient: a modeling analysis. Anesth Analg. 2003;97:1846–1851
  8. Soto RG, Fu ES, Vila H, et al. Capnography accurately detects apnea during monitored anesthesia care. Anesth Analg. 2004;99:379–382
  9. Burton JH, Harrah JD, Germann CA, et al. Does end-tidal carbon dioxide monitoring detect respiratory events prior to current sedation monitoring practices?. Acad Emerg Med. 2006;13:500–504
  10. Miner JR, Heegaard W, Plummer D. End-tidal carbon dioxide monitoring during procedural sedation. Acad Emerg Med. 2002;9:275–280
  11. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 6: advanced cardiovascular life support: section 1: introduction to ACLS 2000: overview of recommended changes in ACLS from the guidelines 2000 conference. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation. 2000;102(8 Suppl):I86–I89
  12. American College of Emergency Physicians . Verification of endotracheal intubation: policy statement. Available at: http://www.acep.org/practres.aspx?id=298462001;[Accessed 2/3/09]
  13. Birmingham PK, Cheney FW, Ward RJ. Esophageal intubation: a review of detection techniques. Anesth Analg. 1986;65:886–891
  14. Knapp S, Kofler J, Stoiser B, et al. The assessment of four different methods to verify tracheal tube placement in the critical care setting. Anesth Analg. 1999;88:766–770
  15. Vaghadia H, Jenkins LC, Ford RW. Comparison of end-tidal carbon dioxide, oxygen saturation and clinical signs for the detection of oesophageal intubation. Can J Anaesth. 1989;36:560–564
  16. Takeda T, Tanigawa K, Tanaka H, et al. The assessment of three methods to verify tracheal tube placement in the emergency setting. Resuscitation. 2003;56:153–157
  17. Bhende MS, Thompson AE, Cook DR, et al. Validity of a disposable end-tidal CO2 detector in verifying endotracheal tube placement in infants and children. Ann Emerg Med. 1992;21:142–145
  18. Guggenberger H, Lenz G, Federle R. Early detection of inadvertent oesophageal intubation: pulse oximetry vs. capnography. Acta Anaesthesiol Scand. 1989;33:112–115
  19. Jemmett ME, Kendall KM, Fourre MW, et al. Unrecognized misplaced endotracheal tubes in a mixed urban to rural EMS setting. Acad Emerg Med. 2003;10:481–482
  20. Wayne MA, Friedland E. Prehospital use of succinylcholine: a 20-year review. Prehosp Emerg Care. 1999;3:107–109
  21. Silvestri S, Ralls GA, Krauss B, et al. The effectiveness of out-of-hospital use of continuous end-tidal carbon dioxide monitoring on the rate of unrecognized misplaced intubation within a regional emergency medical services system. Ann Emerg Med. 2005;45:497–503
  22. van der Windt D. Promises and pitfalls in the evaluation of pediatric asthma scores. J Pediatr. 2000;137:744–746
  23. Kerem E, Tibshirani R, Canny G, et al. Predicting the need for hospitalization in children with acute asthma. Chest. 1990;98:1355–1361
  24. Chalut DS, Ducharme FM, Davis GM. The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity. J Pediatr. 2000;137:762–768
  25. Gorelick MH, Stevens MW, Schultz T, et al. Difficulty in obtaining peak expiratory flow measurements in children with acute asthma. Pediatr Emerg Care. 2004;20:22–26
  26. Eid N, Yandell B, Howell L, et al. Can peak expiratory flow predict airflow obstruction in children with asthma?. Pediatrics. 2000;105:354–358
  27. Geelhoed GC, Landau LI, Le Souef PN. Evaluation of Sao2 as a predictor of outcome in 280 children presenting with acute asthma. Ann Emerg Med. 1994;23:1236–1241
  28. Keahey L, Bulloch B, Becker AB, et al. Initial oxygen saturation as a predictor of admission in children presenting to the emergency department with acute asthma. Ann Emerg Med. 2002;40:300–307
  29. Derrick SJ, Waters H, Kang SW, et al. Evaluation of a nasal/oral discriminate sampling system for capnographic respiratory monitoring. Aana J. 1993;61:509–520
  30. Abramo TJ, Cowan MR, Scott SM, et al. Comparison of pediatric end-tidal CO2 measured with nasal/oral cannula circuit and capillary Pco2. Am J Emerg Med. 1995;13:30–33
  31. Tobias JD, Flanagan JF, Wheeler TJ, et al. Noninvasive monitoring of end-tidal CO2 via nasal cannulas in spontaneously breathing children during the perioperative period. Crit Care Med. 1994;22:1805–1808
  32. Abramo TJ, Wiebe RA, Scott SM, et al. Noninvasive capnometry in a pediatric population with respiratory emergencies. Pediatr Emerg Care. 1996;12:252–254
  33. Plewa MC, Sikora S, Engoren M, et al. Evaluation of capnography in nonintubated emergency department patients with respiratory distress. Acad Emerg Med. 1995;2:901–908
  34. Corbo J, Bijur P, Lahn M, et al. Concordance between capnography and arterial blood gas measurements of carbon dioxide in acute asthma. Ann Emerg Med. 2005;46:323–327
  35. Pianosi P, Hochman J. End-tidal estimates of arterial Pco2 for cardiac output measurement by CO2 rebreathing: a study in patients with cystic fibrosis and healthy controls. Pediatr Pulmonol. 1996;22:154–160
  36. Langhan ML, Zonfrillo MR, Spiro DM. Quantitative end-tidal carbon dioxide in acute exacerbations of asthma. J Pediatr. 2008;152:829–832
  37. Guthrie BD, Adler MD, Powell EC. End-tidal carbon dioxide measurements in children with acute asthma. Acad Emerg Med. 2007;14:1135–1140
  38. Hess D. Capnometry. In:  Tobin MJ editors. Principles and practice of intensive care monitoring. New York (NY): McGraw-Hill; 1998;
  39. van Meerten RJ. Expiratory gas concentration curves for examination of uneven distribution of ventilation and perfusion in the lung. First communication: theory. Respiration. 1970;27:552–564
  40. Muranyi L, Osvath P, Uhl K, et al. Continuous registration of the CO2 contents in expired air (capnography) in the inhalative provocation of children. I. Acetylcholine provocation of asthmatic school-age children. Acta Paediatr Acad Sci Hung. 1969;10:133–154
  41. Poppius H. Expiratory CO2 curve in pulmonary diseases. Scand J Respir Dis. 1969;50:135–146
  42. You B, Peslin R, Duvivier C, et al. Expiratory capnography in asthma: evaluation of various shape indices. Eur Respir J. 1994;7:318–323
  43. Yaron M, Padyk P, Hutsinpiller M, et al. Utility of the expiratory capnogram in the assessment of bronchospasm. Ann Emerg Med. 1996;28:403–407
  44. Kunkov S, Pinedo V, Silver EJ, et al. Predicting the need for hospitalization in acute childhood asthma using end-tidal capnography. Pediatr Emerg Care. 2005;21:574–577
  45. Krauss B, Deykin A, Lam A, et al. Capnogram shape in obstructive lung disease. Anesth Analg. 2005;100:884–888
  46. Smith TC, Proops DW, Pearman K, et al. Nasal capnography in children: automated analysis provides a measure of obstruction during sleep. Clin Otolaryngol Allied Sci. 1993;18:69–71
  47. Magnan A, Philip-Joet F, Rey M, et al. End-tidal CO2 analysis in sleep apnea syndrome. Conditions for use. Chest. 1993;103:129–131
  48. American Thoracic Society. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med. 1996;153:866–878
  49. Blanch L, Romero PV, Lucangelo U. Volumetric capnography in the mechanically ventilated patient. Minerva Anestesiol. 2006;72:577–585
  50. Lucangelo U, Bernabe F, Vatua S, et al. Prognostic value of different dead space indices in mechanically ventilated patients with acute lung injury and ARDS. Chest. 2008;133:62–71
  51. Maslow A, Stearns G, Bert A, et al. Monitoring end-tidal carbon dioxide during weaning from cardiopulmonary bypass in patients without significant lung disease. Anesth Analg. 2001;92:306–313
  52. Verschuren F, Heinonen E, Clause D, et al. Volumetric capnography: reliability and reproducibility in spontaneously breathing patients. Clin Physiol Funct Imaging. 2005;25:275–280
  53. Kline JA, Arunachlam M. Preliminary study of the capnogram waveform area to screen for pulmonary embolism. Ann Emerg Med. 1998;32(3 Pt 1):289–296
  54. Nagler J, Wright RO, Krauss B. End-tidal carbon dioxide as a measure of acidosis among children with gastroenteritis. Pediatrics. 2006;118:260–267

PII: S1522-8401(09)00031-7

doi: 10.1016/j.cpem.2009.03.004

Clinical Pediatric Emergency Medicine
Volume 10, Issue 2 , Pages 82-89 , June 2009