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

The pressure volume loop...

In the pressure-volume loop below, cardiac work is best represented by:   the area of the curve  the slope of the line from points C to D  the distance of the line from points C to D  the slope of a line from points A to D .. .. ... .... ... .... .... .... In the pressure-volume loop below, cardiac work is best represented by:  the area of the curve Cardiac work is the product of pressure and volume and is linearly related to myocardial oxygen consumption. Cardiac work is best represented by the area of the curve of a pressure-volume loop.
Post a Comment
Read more

Anaphylaxis updates part 2- Empty Ventricle Syndrome

Patients with anaphylaxis should not suddenly sit, stand, or be placed in the upright position. Instead, they should be placed on the back with their lower extremities elevated or, if they are experiencing respiratory distress or vomiting, they should be placed in a position of comfort with their lower extremities elevated. This accomplishes 2 therapeutic goals: 1) preservation of fluid in the circulation (the central vascular compartment), an important step in managing distributive shock; and 2) prevention of the empty vena cava/empty ventricle syndrome, which can occur within seconds when patients with anaphylaxis suddenly assume or are placed in an upright position. Patients with this syndrome are at high risk for sudden death. They are unlikely to respond to epinephrine regardless of route of administration, because it does not reach the heart and therefore cannot be circulated throughout the body
Post a Comment
Read more

Steroids In Perioperative period...The Multi-purpose Drugs

1-Steroids are not Bronchodilator ,but have well established usefulness in hyper-reactive airway. They are also said to have a permissive role for bronchodilator medication. They can be administered orally, parenterally or in aerosol form 2- Steroids have been commonly used in chemotherapy for prevention of nausea along with other anti-emetic agents . Dexamethasone was found to be highly effective when given immediately before induction rather than at the end of anesthesia . 3- Steroids do exert analgesic effects. Various routes of administration of steroids include parentral, local infiltration at operated site , as an adjuvant in nerve blocks and central-neuraxial blockade. 4 - Steroids cannot be the mainstay of therapy in anaphylaxis because of the delayed onset of action, so they are used as adjunct after initial treatment with epinephrine. 5- Steroids (Dexamethsone) are of value in reduction or prevention of cerebral edema associated with parasitic infections and neopla...
1 comment
Read more