Skip to main content

ETCO2....the 11 uses



ETCO2  aids the evaluation of the exhaled [CO2], especially end-tidal CO2, which is the maximum partial pressure of CO2exhaled during a tidal breath (just prior to the beginning of inspiration) and is designated PetCO2.
it is highy used in the OR...less in ICU...lesser in other units...
below are the main uses

1. Use as an adjunct to determine that tracheal rather than esophageal intubation has taken place (Low or absent cardiac output may negate its use for this indication.);colorimetric CO2 detectors are adequate devices for this purpose.

2. Monitoring severity of pulmonary disease and evaluating response to therapy, especially therapy intended to improve the ratio of dead
space to tidal volume (VD/VT) and the matching of ventilation to perfusion (V/Q) ,and, possibly, to increase coronary blood flow

3. Continued monitoring of the integrity of the ventilatory circuit, including the artificial airway

4. Evaluation of the efficiency of mechanical ventilatory support by determination of the difference between the arterial partial pressure for CO2 (PaCO2) and the PetCO2
5. Monitoring adequacy of pulmonary, systemic, and coronary blood flow

6. Estimation of effective (nonshunted) pulmonary capillary blood flow by a partial rebreathing method.

7. Use as an adjunctive tool to screen for pulmonary embolism (Evidence for the utility of dead space determinations as a screening tool for pulmonary embolism is at present not conclusive.)

8. Monitoring the matching of ventilation to perfusion during independent lung ventilation for unilateral pulmonary contusion

9. Monitoring inspired CO2 when CO2 gas is being therapeutically administered
10. Graphic evaluation of the ventilator-patient interface; evaluation of the shape of the capnogram may be useful in detecting rebreathing of
CO2, obstructive pulmonary disease, waning neuromuscular blockade (‘curare cleft’), cardiogenic oscillations, esophageal intubation, cardiac arrest, and contamination of the monitor or sampling line with secretions or mucus.
11- Measurement of the volume of CO2 elimination to assess metabolic rate as what happens in malignant hyperthermia,thyroid storm....et

Labels:

Comments

Post a Comment

Popular posts from this blog

power injectable peripherally inserted central catheters

Clinical experience with power injectable peripherally inserted central catheters in intensive care patients     Introduction In intensive care units (ICU), peripherally inserted central catheters (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome by the use of power-injectable catheters . Method We have retrospectively reviewed all the power injectable PICCs inserted in adult and pediatric patients in the ICU during a 12-month period, focusing on the rate of complications at insertion and during maintenance. Results We have collected 89 power injectable PICCs (in adults and in children), both multiple and single lumen. All insertions were successful. There were no major complications at insertion and no episodes of catheter-related blood stream infection. Non-infective complications ...
1 comment
Read more

The 12 decision making steps for post dural puncture headache treatment

Treatment decision-making algorithm for postdural puncture headache. 1. When diagnosis is made, all patients should receive supportive measures (reassurance, bed rest, analgesics, hydration, quiet environment). 2. Severity of symptoms should be classified using VAS scale (mild 1–3, moderate 4–6, severe 7–10). 3. Virtually all patients will improve in time even without additional therapy. (dashed lines) 4. Symptoms worsen or fail to resolve within 5 days. 5. Patient preference dictates the choice between pharmacologic (less effective) and epidural blood patch (EBP). 6. In patients with severe symptoms, EBP is strongly suggested. 7. The most common pharmacologic measure is  caffeine  prescription. 8. The failure, worsening, or recurrence of symptoms after pharmacologic measures favors the use of EBP. 9. In addition to EBP, other epidural treatment options can be considered in select patients (eg,  dextran , saline). 10. A period of 24 h should lapse before repeating EBP. 11...
1 comment
Read more

Things to Avoid in Anesthesia for Pregnant with Pulmonary hypertension

Anesthesia for Pregnant woman with Pulmonary Hypertension is a real challenge for anesthesiologist. It is very crucial to remember the pathophysiology of pulmonary hypertension in pregnant women and to avoid some practices that will worsen the cardiac status. 1-Avoid single shot spinal anesthesia. Some authorities consider pulmonary hypertension as absolute contraindication for single shot spinal anesthesia specially in patients with NYHA III ,IV. Spinal anesthesia causes major hemodynamic instability(decrease SVR, decrease VR, decrease in CO) The preferred neuroaxial techniques are (epidural anesthesia and CSE with minimal spinal dose) 2-Avoid PAC. Pulmonary Artery catheters insertion may lead to pulmonary artery rupture or thrombosis. TEE is better cardiac monitor/Arteial line is mandatory. 3-Avoid Nitrous oxide in gas mixture.N2O increase the PVR 4-If MV to be started, avoid High TV and PEEP 5-Avoid Oxytocin Boluses, or rapid administration of Pitocin. Oxytocin causes ...
Post a Comment
Read more