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Accuracy of End-Tidal Co(2) Capnometers in Post-Cardiac Surgery Patients During Controlled Mechanical Ventilation.
MedLine Citation:
PMID:  23375221     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The determination of end-tidal carbon dioxide (etCO(2)) is very helpful in cardiac resuscitation for confirmation and monitoring of endotracheal tube placement and as an indicator of return of circulation and effectiveness of chest compressions. There is now also widespread use of capnometry on-site at emergency and trauma fields. OBJECTIVE: We studied the accuracy and correlation of three capnometers (EMMA, Medtronic, and Evita) with partial pressure of arterial CO(2) (PaCO(2)) measurements. METHODS: The three capnometers were placed in-line in the ventilator tubing of the patient. Forty sedated and mechanically ventilated post-cardiac surgery patients were studied. Twenty consecutive etCO(2) values were collected simultaneously from all three monitors while drawing an arterial blood sample. Paired sample t-test and Pearson correlation were used to compare the capnometers and their correlation with PaCO(2). RESULTS: The correlation of etCO(2) measurements between all three capnometers was good (Emma vs. Evita: 0.874, Emma vs. Medtronic: 0.949, Evita vs. Medtronic: 0.878). The correlation of PaCO(2) with the Evita is the lowest (0.671) as compared to the EMMA (0.693) and the Medtronic (0.727). The lowest dispersion of the difference between etCO(2) and PaCO(2) was seen in EMMA (3.30), the highest in Evita (3.98). CONCLUSIONS: A good correlation between etCO(2) and PaCO(2) was shown with the three capnometers in the present study. However, etCO(2) measurements were not valid to estimate PaCO(2) in these patients. Therefore, capnometry cannot be used to replace serial blood gas analyses completely, but may be a good cardiopulmonary trend monitor and alerting system in catastrophic events.
Authors:
Serge J H Heines; Ulrich Strauch; Paul M H J Roekaerts; Bjorn Winkens; Dennis C J J Bergmans
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-30
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  -     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Intensive Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
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