Capnography during sedation/analgesia in the pediatric emergency department

McQuillen, Kemedy K.; Steele, Dale W.

doi:10.1097/00006565-200012000-00005

Cited by 86 publications

(42 citation statements)

References 13 publications

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“…A change in ETCO 2 level R10 mm Hg from the presedation baseline and an intrasedation ETCO 2 level %30 mm Hg or R50 mm Hg were considered investigational acute respiratory events. 4,[6][7][8][9] For observed acute respiratory events, the type and time of the acute respiratory events were entered into the monitor along with the clinical assessment and vital sign data at that time.…”

Section: Outcome Measuresmentioning

confidence: 99%

Does End-tidal Carbon Dioxide Monitoring Detect Respiratory Events Prior to Current Sedation Monitoring Practices?

Burton¹,

Harrah²,

Germann³

et al. 2006

Acad Emergency Med

112

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Objectives: The value of ventilation monitoring with end-tidal carbon dioxide (ETCO 2 ) to anticipate acute respiratory events during emergency department (ED) procedural sedation and analgesia (PSA) is unclear. The authors sought to determine if ETCO 2 monitoring would reveal findings indicating an acute respiratory event earlier than indicated by current monitoring practices. Methods:The study included a prospective convenience sample of ED patients undergoing PSA. Clinicians performed ED PSA procedures with generally accepted patient monitoring, including oxygen saturation (SpO 2 ), and clinical ventilation assessment. A study investigator recorded ETCO 2 levels and respiratory events during each PSA procedure, with clinical providers blinded to ETCO 2 levels. Acute respiratory events were defined as SpO 2 %92%, increases in the amount of supplemental oxygen provided, use of bag-valve mask or oral/nasal airway for ventilatory assistance, repositioning or airway alignment maneuvers, and use of physical or verbal means to stimulate patients with depressed ventilation or apnea, and reversal agent administration.Results: Enrollment was stopped after independent review of 20 acute respiratory events in 60 patient sedation encounters (33%). Abnormal ETCO 2 findings were documented in 36 patients (60%). Seventeen patients (85%) with acute respiratory events demonstrated ETCO 2 findings indicative of hypoventilation or apnea during PSA. Abnormal ETCO 2 findings were documented before changes in SpO 2 or clinically observed hypoventilation in 14 patients (70%) with acute respiratory events.Conclusions: Abnormal ETCO 2 findings were observed with many acute respiratory events. A majority of patients with acute respiratory events had ETCO 2 abnormalities that occurred before oxygen desaturation or observed hypoventilation.

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Section: Outcome Measuresmentioning

confidence: 99%

Does End-tidal Carbon Dioxide Monitoring Detect Respiratory Events Prior to Current Sedation Monitoring Practices?

Burton¹,

Harrah²,

Germann³

et al. 2006

Acad Emergency Med

112

View full text Add to dashboard Cite

show abstract

“…Pulse oximetry measures oxygen saturation but this only provides a late alarm and may be adversely affected after an unreasonable depression has occurred in respiration. Mcquillen et al [2] and Tobias [3] both found that end-tidal CO 2 monitoring enabled the early detection of respiratory depression. Whilst Miner et al [4] concluded that end-tidal CO 2 enhanced safety and detected subclinical respiratory depression.…”

Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 99%

“…There is a strong association between low spine anomalies and genitourinary and colorectal structures [1,2]. Genitourinary, colorectal, and musculoskeletal systems are all of mesodermal origin and develop at the same time in the embryo, so that any insult inducing congenital vertebral malformations during organogenesis may also lead to congenital genitourinary or colorectal abnormalities [2].…”

Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 99%

“…Genitourinary, colorectal, and musculoskeletal systems are all of mesodermal origin and develop at the same time in the embryo, so that any insult inducing congenital vertebral malformations during organogenesis may also lead to congenital genitourinary or colorectal abnormalities [2]. If genitourinary anomalies are combined with VACTERL syndrome, there is a high incidence of tethered spinal cord [3].…”

Section: ó 2009 the Association Of Anaesthetists Of Great Britain Andmentioning

confidence: 99%

“…Respiratory and particularly airway complications have been highlighted as a leading cause of morbidity and mortality in the US closed claims analysis. Caplan suggested that most were preventable with a strategy for dealing with difficult intubation [2]. As a result, the American Society of Anesthesiologists [3], and at a later date the Difficult Airway Society [4] provided a framework for the anaesthetist to manage the unanticipated difficult airway.…”

mentioning

confidence: 99%

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