Volume Capnography in the Intensive Care Unit: Potential Clinical Applications.

Volume capnography provides a noninvasive, continuous display of the fractional concentration or partial pressure of carbon dioxide (Pco) versus exhaled volume. Derived measurements and calculations are influenced by changes in both ventilation and perfusion and are therefore useful for assessing both respiratory and cardiovascular function. This article provides an evidence-based review of several potential uses of volume capnography in the intensive care unit: 1) monitoring the effectiveness of ventilation by using end-tidal Pco as a surrogate for arterial Pco, 2) assessing volume responsiveness, 3) measuring cardiac output, 4) determining prognosis in patients with the acute respiratory distress syndrome, 5) optimizing alveolar recruitment, and 6) excluding pulmonary embolism.

Volume Capnography in the Intensive Care Unit: Physiological Principles, Measurements, and Calculations.

Volume capnography provides a noninvasive and continuous display of the fractional concentration or partial pressure of expired carbon dioxide versus exhaled volume. Derived measurements and calculations include the end-tidal, mean alveolar, and mixed expired carbon dioxide partial pressure (Pco); the volume of CO exhaled per breath and per minute; the airway, alveolar, and physiologic dead space volume; the physiologic dead space to tidal volume ratio; and expired minute ventilation, dead space ventilation, and alveolar ventilation. Thus, volume capnography provides a wealth of information about both respiratory and cardiovascular function, and it has many potential applications in critically ill patients.

Isolation of Aspergillus in three 2009 H1N1 influenza patients.

Objectives: To describe the association of Aspergillus with influenza.

Design/setting/sample: Three case reports of ICU patients with influenza complicated by the isolation of Aspergillus species are described and a review of the literature on the topic was performed.

Conclusions: Severe influenza cases can be complicated by Aspergillus infection.

The impact of right ventricular dysfunction on the prognosis and therapy of normotensive patients with pulmonary embolism.

The prognosis and optimal therapy of patients with pulmonary embolism (PE) are strongly influenced by the presence or absence of associated hemodynamic derangements. Patients with normal systemic arterial pressure have a relatively low risk of recurrent PE and death when treated promptly with therapeutic anticoagulation. Those who present with hypotension, shock, or cardiac arrest, however, have a much higher mortality rate and often receive thrombolytic therapy.