Capnography facilitates tight control of ventilation during transport

Sally C. Palmon, Maywin Liu, Laurel E. Moore, Jeffrey Kirsch

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Objective: We tested the hypothesis that PaCO2 would be more tightly controlled if end-tidal CO2 monitoring was used during hand ventilation for transport of intubated patients. Design: Randomized, prospective analysis of the no-monitor and monitor-blind groups (the monitor was on the bed during transport but only the Investigator was aware of the end-tidal CO2 values). Nonrandomized, prospective analysis of the monitor group (ventilation controlled using end-tidal CO2 value from monitor). Setting: University hospital operating room and intensive care unit (ICU). Patients: Fifty intubated patients who were transported from the operating room to the ICU or from the ICU to the neuroradiology suits were assigned randomly to one of two groups: a) no-monitor group (n = 25); and b) monitor-blind group (n = 25). An additional group (monitor group, n = 10) was subsequently added to the study. Interventions: Capnography was instituted in all patients in a blocked fashion. Measurements end Main Results: Arterial blood gases and end-tidal CO2 values were measured before and after transport. When comparing overall group data, pre- and post. PaCO2 values were similar: monitor 39 ± 2 vs. 41 ± 2 torr (5.2 ± 0.3 vs. 5.5 ± 0.3 kPa); monitor-blind 39 ± 1 vs. 39 ± 2 torr (5.2 ± 0.1 vs. 5.2 ± 0.3 kPa); no-monitor 39 = 1 vs. 37 ± torr (5.2 ± 0.1 vs. 5.0 ± 0.1 kPa). However, when comparing PaCO2 values for individual patients, we found that there was significantly greater variability for PaCO2 after transport when end-tidal CO2 was not used for control of ventilation during transport. Conclusions: These data do not support routine monitoring of end-tidal CO2 during short transport times in adult patients requiring mechanical ventilation. However, the monitor may prevent morbidity in patients requiring tight control of PaCO2.

Original languageEnglish (US)
Pages (from-to)608-611
Number of pages4
JournalCritical Care Medicine
Volume24
Issue number4
DOIs
Publication statusPublished - Apr 1996
Externally publishedYes

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Keywords

  • anesthesia
  • capnography
  • critical illness
  • end-tidal CO
  • endotracheal intubation
  • mechanical ventilation
  • monitoring
  • pulmonary emergencies

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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