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Updated: Jul 9, 2025
07:52
Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
16.2K
Quantifying hospital environmental ventilation using carbon dioxide monitoring - a multicentre study
N M Wilson1,2, C Calabria1, A Warren1
1Department of Anaesthesia and Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK.
Anaesthesia
|December 7, 2023
Summary
Hospital ventilation quality varies significantly. Staff areas and general wards often show inadequate ventilation, increasing airborne transmission risks. Intensive care units and operating theaters maintain high ventilation standards, suggesting carbon dioxide monitoring can guide improvements.
Area of Science:
- Environmental Health
- Hospital Infrastructure
- Infectious Disease Control
Background:
- The COVID-19 pandemic underscored the critical role of environmental ventilation in mitigating airborne pathogen transmission.
- Current hospital ventilation assessment relies on static air change rates, not dynamic measurements of exhaled waste gas.
- Carbon dioxide monitoring is a recommended community tool for assessing ventilation adequacy.
Purpose of the Study:
- To dynamically quantify and assess the quality and distribution of hospital ventilation.
- To investigate the relationship between human occupancy, ventilation, and carbon dioxide levels.
- To compare ventilation quality in clinical and non-clinical hospital areas.
Main Methods:
- A two-phased prospective observational study using non-dispersive infrared carbon dioxide monitors.
- Phase 1: Validation of the method under controlled conditions.
- Phase 2: Assessment of ventilation in 32 clinical and non-clinical areas across two Scottish hospitals over 8 weeks (November-December 2022), collecting 127,680 measurements.
Main Results:
- Carbon dioxide levels exceeded 800 ppm for 14% of the time in non-clinical areas versus 7% in clinical areas (p < 0.001).
- In non-clinical settings, CO2 levels were >800 ppm 20% of the time in ICUs and wards, but only 1% in operating theaters (p < 0.001).
- In clinical settings, CO2 levels were >800 ppm 16% of the time in wards, but 0% in ICUs and operating theaters (p < 0.001).
Conclusions:
- Staff break rooms, offices, and clinical areas on acute medical/respiratory wards frequently exhibit inadequate ventilation, potentially elevating airborne pathogen transmission risks.
- Ventilation quality was consistently high in Intensive Care Units (ICUs) and operating theaters.
- Carbon dioxide monitoring offers a viable method for measuring and guiding improvements in hospital environmental ventilation.
Keywords:
COVID-19SARS-CoV-2carbon dioxideinfectious disease transmissionnosocomial infectionsrespiratory aerosolsventilationMore Related Videos
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