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Capnography

B D Schmitz1, B A Shapiro

  • 1Department of Respiratory Care, Northwestern Memorial Hospital, Chicago, Illinois, USA.

Respiratory Care Clinics of North America
|September 1, 1995
PubMed
Summary
This summary is machine-generated.

Capnography, measuring exhaled carbon dioxide, is highly valuable for direct patient care like detecting tracheal tube misplacement and assessing resuscitation. Its reliability decreases when estimating alveolar ventilation (PaCO2), especially in critically ill patients.

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Respiratory Physiology

Background:

  • Capnography measures exhaled carbon dioxide (CO2).
  • Its clinical utility is highest in direct patient monitoring applications.
  • Less reliable for reflecting alveolar ventilation (PaCO2).

Purpose of the Study:

  • To evaluate the clinical utility of capnography.
  • To identify optimal and least reliable applications of capnography.
  • To discuss capnography's limitations in severe respiratory failure.

Main Methods:

  • Review of capnography applications in patient care.
  • Analysis of capnography's role in detecting tracheal tube misplacement, respiratory dysfunction, and guiding resuscitation.
  • Evaluation of capnography for estimating PaCO2 during anesthesia and mechanical ventilation weaning.

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  • Assessment of factors affecting capnography accuracy in severe respiratory failure.

    • Main Results:

    • Capnography is most useful for detecting tracheal tube misplacement, respiratory apparatus dysfunction, abnormal lung function, successful cardiopulmonary resuscitation, and trending deadspace changes.
    • Capnography is least reliable for reflecting alveolar ventilation (PaCO2), particularly during general anesthesia and mechanical ventilation weaning.
    • PETCO2 monitoring can estimate PaCO2 in stable patients without lung disease.
    • In severe respiratory failure, V/Q mismatch and increased peripheral CO2 production can cause erroneous PETCO2 values, limiting capnography's utility.

    Conclusions:

    • Capnography is a vital tool for direct patient monitoring and resuscitation.
    • Its application in estimating alveolar ventilation (PaCO2) is limited and requires careful consideration of patient stability.
    • Capnography's utility is significantly reduced in the sickest patients with severe respiratory failure.