End-tidal CO2 (ETCO2) monitoring is not a new modality in the pediatric emergency department (PED) and emergency department. It is the standard of care during certain procedures such as intubations and sedations and can be used in variety of clinical situations. However, ETCO2 may be underused in the PED setting. The implementation of ETCO2 monitoring may be accomplished many ways, but a foundation of capnography principles specifically in ventilation, cardiac output, and current literature regarding its application is essential to successful implementation. It is the intention of this article to briefly review the principles of ETCO2 monitoring and its clinical applications in the PED setting.
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http://dx.doi.org/10.1097/PEC.0000000000001682 | DOI Listing |
Braz J Anesthesiol
January 2025
Zhongshan City People's Hospital, Department of Anesthesiology, Zhongshan, China.
Background: Extracorporeal Cardiopulmonary Resuscitation (ECPR) is an effective intervention for restoring adequate circulatory perfusion after cardiac arrest. Ensuring high-quality Cardiopulmonary Resuscitation (CPR) before initiating Extracorporeal Membrane Oxygenation (ECMO) is critical to mitigate tissue hypoxia and ischemia. This study aimed to evaluate the effect of End-Tidal Carbon Dioxide (ETCO) Goal-Directed CPR (GDCPR) on neurological function before ECMO using a retrospective case-control analysis.
View Article and Find Full Text PDFJ Hepatobiliary Pancreat Sci
January 2025
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Background/purpose: Insufficient studies exist on capnography efficacy during endoscopic ultrasound or endoscopic retrograde cholangiopancreatography, and no definitive conclusions have been drawn. To evaluate the feasibility and efficacy of a novel mainstream capnography using an over-the-biteblock end-tidal CO (EtCO) detector in decreasing the risk of hypoxemia during endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP).
Methods: Patients undergoing EUS or ERCP with conscious sedation at a single Japanese center were randomized to a control or a novel capnography monitored (intervention) group in a 1:1 ratio.
Am J Emerg Med
January 2025
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain; Emergency Department, Hospital Clínico Universitario, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain.
Background: The study of the inclusion of new variables in already existing early warning scores is a growing field. The aim of this work was to determine how capnometry measurements, in the form of end-tidal CO2 (ETCO2) and the perfusion index (PI), could improve the National Early Warning Score (NEWS2).
Methods: A secondary, prospective, multicenter, cohort study was undertaken in adult patients with unselected acute diseases who needed continuous monitoring in the emergency department (ED), involving two tertiary hospitals in Spain from October 1, 2022, to June 30, 2023.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
December 2024
Department of Emergency Medicine, Shenzhen University General Hospital, Shenzhen 518071, Guangdong, China.
Prehospital emergency care is the primary stage in the treatment of critically ill patients, where efficient and accurate monitoring methods are crucial for patient survival and prognosis. End-tidal carbon dioxide (EtCO) monitoring is a real-time, non-invasive method that can sensitively capture the status of respiratory, circulatory, and metabolic functions, particularly in the urgent and complex pre-hospital environment, a immediate detection and non-invasive method, can sensitively capture the respiratory, circulatory, and metabolic status of patients. It provides valuable guidance for rapid decision-making and precise interventions.
View Article and Find Full Text PDFJ Robot Surg
January 2025
Department of Pediatric Anesthesia and Intensive Care, Necker-Enfants Malades University Hospital, AP-HP Centre, Université Paris Cité, 149, Rue de Sèvres 75015, Paris, France.
Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) is the commonest urologic procedure performed in children, entailing retroperitoneal CO2 insufflation and lateral decubitus, whose effects on cardiopulmonary variables are poorly known. We, therefore, studied hemodynamic and respiratory changes due to CO2 insufflation and lateral decubitus in children undergoing R-RALP and their effects on regional tissue oxygenation. Between 1/2021 and 7/2024, children affected by ureteropelvic joint obstruction (UPJO) underwent a pyeloplasty by R-RALP at Necker Enfants Malades Hospital (Paris, France), using a standardized surgical technique and a lung-protecting anesthetic protocol aimed to prevent hypercarbia.
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