ACCURACY OF END-TIDAL CO2 CAPNOMETERS IN POST-CARDIAC SURGERY PATIENTS DURING CONTROLLED MECHANICAL VENTILATION

Serge J. H. Heines*, Ulrich Strauch, Paul M. H. J. Roekaerts, Bjorn Winkens, Dennis C. J. J. Bergmans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Web of Science)

Abstract

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 CO2 (PaCO2) 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 PaCO2. 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 PaCO2 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 PaCO2 was seen in EMMA (3.30), the highest in Evita (3.98). Conclusions: A good correlation between etCO(2) and PaCO2 was shown with the three capnometers in the present study. However, etCO(2) measurements were not valid to estimate PaCO2 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.
Original languageEnglish
Pages (from-to)130-134
JournalThe Journal of Emergency Medicine
Volume45
Issue number1
DOIs
Publication statusPublished - Jul 2013

Keywords

  • end-tidal carbon dioxide
  • capnography
  • capnometer
  • monitoring
  • carbon dioxide
  • blood gas analysis

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