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

Falling from Height...The Prognostic factors

Falls from Height is Knwon to cause major morbidities and mortalities.  There are several prognostic factors for survival that have been identified: Height Age Type of surface Body part that touches the ground first Two other factors are important, but do not have a significant effect on mortality: Circumstances of the fall (suicide, accident, escape) Initial impact with an object before impacting the ground Height . Overall, about half of victims die at the scene, and a total of 70% die before they reach the hospital . The median height leading to death is about 49 feet, or about 4 to 5 storeys. 100% of victims die after falling 85 feet, or about 8 storeys. Age . Mortality increases with age due to pre-existing medical conditions and decreased physiologic reserve. Type of surface . The type of surface struck (i.e. grass, water, construction debris) can also have an effect on secondary injuries and survival. Mortality after striking a hard surface is nearly doubl...
Post a 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