Benefits and harms of capnography during procedures involving moderate sedation

Parker, William A.; Estrich, Cameron; Abt, Elliot; Carrasco-Labra, Alonso; Waugh, Jonathan B.; Conway, Aaron; Lipman, Ruth D.; Araujo, Marcelo W B

doi:10.1016/j.adaj.2017.08.030

Cited by 15 publications

(11 citation statements)

References 43 publications

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“…Although much of the literature has recommended the clinical applications of capnography [22,[49][50][51], a scoping review revealed a link between capnography usage and a reduction in serious airway complications in the operating room, ICU, and emergency department and during resuscitation [52]. The 2020 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care emphasize the use of capnography for intubated patients during CPR, and continuous wave-form capnography, along with clinical assessment, remains the most reliable method of confirming and monitoring correct ETT placement [53].…”

Section: Discussionmentioning

confidence: 99%

Applications of capnography in airway management outside the operating room

2021

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The capnograph is vital for patient monitoring in the operating room. Its clinical applications for airway management outside the operating room are being increasingly recognized due to its role in the Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guidelines. Capnography can be used for the detection of respi-ratory depression during procedural sedation, verification after emergency endotracheal tube intubation, assessment of the airway and circulation during cardiopulmonary resuscitation, and continuous monitoring during patient transportation and in intensive care settings. This can be especially beneficial for pediatric patients, those who are critically ill, and patients with a difficult airway.

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Section: Discussionmentioning

confidence: 99%

Applications of capnography in airway management outside the operating room

2021

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“…However, various respiratory rate monitoring methodologies have been introduced, such as impedance pneumography (measures respiratory rate via electrodes on the chest wall) [ 9 ], piezoelectric plethysmography, or fiberoptic plethysmography [ 10 ]. However, in clinical practice, capnography, which measures partial pressure of CO 2 , is the generally accepted method for respiratory rate measurement during sedation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of dental scaling noise during intravenous sedation on acoustic respiration rate (RRa™)

Kim

et al. 2018

J Dent Anesth Pain Med

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BackgroundRespiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate (RRa™), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement.MethodsWe analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram.ResultsRespective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were −0.03, −0.27, and −0.61 in each respective period (P < 0.001); limits of agreement were −4.84–4.45, −4.89–4.15, and −6.18–4.95 (P < 0.001).ConclusionsThe probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

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“…The initial studies, which were exploratory, sought to draw a parallel between dentistry and patient safety 9,10,16,17,18,19,20 . These then gave way to more specific approaches 21,22 , suggesting greater participation by Dentistry in the multidisciplinary approach that the patient safety theme requires.…”

Section: Focus On Patient Safety In Dentistrymentioning

confidence: 99%

“…In order to improve safety in anesthesia, adequate monitoring and a highly trained team were identified as key factors 80,81 . In addition, a systematic review suggested the routine addition of capnography to standard monitoring of adults during moderate sedation 22 .…”

Section: The Solutions Identified and Their Contribution To Improvemementioning

confidence: 99%

Segurança do paciente no cuidado odontológico: revisão integrativa

2020

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Resumo: Eventos adversos constituem grave problema relacionado à qualidade do cuidado de saúde. A prática odontológica, por ser eminentemente invasiva e implicar contato íntimo e rotineiro com secreções, é potencialmente propícia à ocorrência desses eventos. Diversos estudos em segurança do paciente foram desenvolvidos nas duas últimas décadas, entretanto, em maior número no ambiente hospitalar, em função de sua complexidade organizacional, gravidade de casos, diversidade e especificidade de procedimentos. O objetivo foi identificar e explorar os estudos voltados à segurança do paciente odontológico. Foi realizada revisão integrativa da literatura com consulta ao MEDLINE via PubMed, Scopus via Portal Capes e ao Portal Regional da Biblioteca Virtual de Saúde, utilizando-se os termos segurança do paciente e odontologia nos idiomas inglês, espanhol e português a partir de 2000. Utilizou-se o ciclo de pesquisa em segurança do paciente, proposto pela Organização Mundial da Saúde para classificar os estudos incluídos. Foram analisados 91 artigos. Os eventos adversos mais comuns foram relacionados às alergias, às infecções, ao atraso ou falha de diagnóstico e ao erro da técnica. Medidas para mitigar o problema apontaram para a necessidade de melhoria da comunicação, incentivo à notificação e procura por instrumentos para auxiliar a gestão do cuidado. Constatou-se carência de estudos de implementação e avaliação de impacto das propostas de melhoria. A Odontologia evoluiu no campo da segurança do paciente, mas ainda está aquém de transpor resultados para a prática, sendo importante envidar esforços para prevenir os eventos adversos nesta área.

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Benefits and harms of capnography during procedures involving moderate sedation

Cited by 15 publications

References 43 publications

Applications of capnography in airway management outside the operating room

Applications of capnography in airway management outside the operating room

The effect of dental scaling noise during intravenous sedation on acoustic respiration rate (RRa™)

Segurança do paciente no cuidado odontológico: revisão integrativa

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