Document Detail


Monitoring of the inspired and end-tidal oxygen, carbon dioxide, and nitrous oxide concentrations: clinical applications during anesthesia and recovery.
MedLine Citation:
PMID:  2504889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Respiratory oxygen, carbon dioxide, and nitrous oxide concentrations were recorded in 20 patients breath-by-breath during general anesthesia and early recovery, using the Cardiocap multiparameter monitor. Several approved maneuvers were performed to demonstrate the usefulness of endtidal oxygen measurement. "Oxygrams" provided by the fast paramagnetic oxygen sensor confirmed the capnometric information in the diagnosis of hypoventilation, apnea, and disconnections. In one patient, the alarm for inspiratory oxygen concentration, set at 18%, appeared to prevent alveolar hypoxia and low arterial saturation from occurring when oxygen instead of nitrous oxide was turned off. Low end-tidal oxygen levels revealed inadequate fresh gas oxygen supplementation while low flow circuits were closed. During manual hypoventilation at the end of anesthesia, the inspiratory-expiratory oxygen difference increased almost twofold while end-tidal carbon dioxide increased by only 30%. Changes in nitrous oxide concentration often complemented oxygen-related information obtained in our observations. In the recovery room, a decrease in end-tidal oxygen concentration preceded low pulse oximetry readings. Therefore, it is suggested that all three gases should be monitored continuously to prevent mishaps related to insufficient ventilation and inappropriate gas concentrations during anesthesia and immediate recovery.
Authors:
K Linko; M Paloheimo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical monitoring     Volume:  5     ISSN:  0748-1977     ISO Abbreviation:  J Clin Monit     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-09-29     Completed Date:  1989-09-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8506707     Medline TA:  J Clin Monit     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  149-56     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Helsinki University Central Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery*
Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia, General / instrumentation*
Anoxia / blood
Apnea / blood
Blood Gas Analysis / instrumentation*
Carbon Dioxide / blood*
Female
Humans
Intraoperative Complications / blood
Male
Middle Aged
Nitrous Oxide / pharmacokinetics*
Oximetry / instrumentation
Oxygen / blood*
Tidal Volume
Chemical
Reg. No./Substance:
10024-97-2/Nitrous Oxide; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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