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Published on: September 29, 2020
Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue by Hospital Rapid Resuscitation
Mindy Stites1, Jennifer Surprise1, Jennifer McNiel2
1From the Departments of Nursing.
Objective:
The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response.
Methods:
A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015. In March 2013, continuous capnography monitoring was implemented for all patients using PCA.
Results:
The preintervention incidence of OIRD in the setting of rapid response was 0.4% of patients receiving opioids. After the implementation of capnography, the incidence of OIRD in the setting of rapid response was reduced to 0.2%, which was statistically significant (χ2 = 46.246; df, 1; P < 0.0001). The rate of transfers to a higher level of care associated with these events was also reduced by 79% (baseline, 7.6 transfers/month; postintervention, 1.6 transfers/month).
Conclusions:
Continuous capnography monitoring in patients receiving PCA significantly reduces the incidence of OIRD in the setting of rapid response and unplanned transfers to a higher level of care.
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