Quantitative Analysis of the Effect of Prolonged Mechanical Ventilation on Capnographic Indices

Carmen Caroline Rasera, Pedro Miguel Gewehr, Adriana Maria T. Domingues

2013

Abstract

The monitoring of carbon dioxide pressure through Capnography has been clinically used as a continuous and non-invasive measurement of alveolar ventilation. The patients with lung disease, respiratory and hemodynamic instability and when in mechanical ventilation have a significant alteration in the waveform of the capnogram. In this study, quantitative analysis between capnographic indices of the patients under prolonged mechanical ventilation were obtained and compared to waveforms of spontaneously breathing patients. The measurements were performed at the 10th day of invasive mechanical ventilation and 48 hours after tracheal extubation, totalling 52 capnographic curves. PaCO2 and PetCO2 measurements maintained a significant correlation in spontaneously breathing patients (r2 = 0.97, p<0.001) and a weak correlation in patients during prolonged mechanical ventilation (r2 = 0.86). Four waveform parameters (intermediate slope, alpha angle, beta angle and area ratio) were identified as altered. These altered parameters can provide guidance to physicians about the physiological interpretation of capnograms and clinical decision. Proper interpretation of the capnogram can alert a clinician to important changes in mechanical ventilatory parameters in order to obtain a capnographic wave closest to normal thereby improving the lung function of patients.

References

  1. Belpomme, V., et al., 2005. Correlation of arterial PCO2 and PetCO2 in prehospital controlled ventilation. American Journal of Emergency Medicine, vol. 23, pp. 852-859.
  2. Benallal, H., Busso, T., 2000. Analysis of end-tidal and arterial PCO2 gradients using a brething model. Eur J Appl Physiol, vol. 83, pp. 402-408.
  3. Cheifetz, I. M., Myers, T. R., 2007. Should every mechanically ventilated patient be monitored with capnography from intubation to extubation? Respir Care, vol. 52, pp. 423-442.
  4. Domingo, C., Blanch, L., Murias, G., Luján, M., 2010. State of the art sensor technology in Spain: Invasive and non-invasive techniques for monitoring respiratory variables. Sensors, vol. 10, pp. 4655-4674.
  5. Gravenstein, J. S., Jaffe, M. B., Gravenstein, N., Paulus, D. A., 2011. Capnography. Cambridge, 2nd edition.
  6. Hagerty, J. J., Kleinman, M. E., Zurakowski, D., et al., 2002. Accuracy of a new low-flow sidestream capnography technology in newborns. Journal of Perinatology, vol. 22, pp. 219-225.
  7. Langhan, M., 2009. Continuous end-tidal carbon dioxide monitoring in pediatric intensive care unit. J Crit Care, vol. 24, pp. 227-230.
  8. Op Den Buijs, J., Warner, L., Chbat, N. W., Roy, T. K., 2006. Bayesian tracking of a nonlinear model of the capnogram. Conf Proc IEEE Eng Med Biol Soc, vol. 1, pp. 2871-2874.
  9. Roy, T. K., Den Buij, J., 2007. Calculating the effect of altered respiratory parameters on capnographic indices. IFMBE Proceedings, vol. 14, pp. 123-126.
  10. Thompson, J. E., Jaffe, M. B., 2005. Capnographic waveforms in the mechanically ventilated patient. Respir Care, vol. 50, pp. 100-108.
  11. You, B., Peslin, R., Duvivier, C., et al., 1994. Expiratory capnography in asthma. Eur Respir J, vol. 7, pp. 318- 323.
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Paper Citation


in Harvard Style

Rasera C., Gewehr P. and T. Domingues A. (2013). Quantitative Analysis of the Effect of Prolonged Mechanical Ventilation on Capnographic Indices . In Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2013) ISBN 978-989-8565-34-1, pages 253-256. DOI: 10.5220/0004229102530256


in Bibtex Style

@conference{biodevices13,
author={Carmen Caroline Rasera and Pedro Miguel Gewehr and Adriana Maria T. Domingues},
title={Quantitative Analysis of the Effect of Prolonged Mechanical Ventilation on Capnographic Indices},
booktitle={Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2013)},
year={2013},
pages={253-256},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0004229102530256},
isbn={978-989-8565-34-1},
}


in EndNote Style

TY - CONF
JO - Proceedings of the International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2013)
TI - Quantitative Analysis of the Effect of Prolonged Mechanical Ventilation on Capnographic Indices
SN - 978-989-8565-34-1
AU - Rasera C.
AU - Gewehr P.
AU - T. Domingues A.
PY - 2013
SP - 253
EP - 256
DO - 10.5220/0004229102530256