Deep Breathing Improves End-Tidal Carbon Dioxide Monitoring of an Oxygen Nasal Cannula-Based Capnometry Device in Subjects Extubated After Abdominal Surgery

Takaki, Satoshi; Mizutani, Kenji; Fukuchi, Moeka; Yoshida, Tasuku; Idei, Masahumi; Matsuda, Yuko; Yamaguchi, Yoshikazu; Miyashita, Tetsuya; Nomura, Takayoshi; Yamaguchi, Osamu; Goto, Takahisa

doi:10.4187/respcare.04634

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Another study reported that while ETCO 2 readings with supplemental oxygen during simulated normal ventilation were normal, ETCO 2 readings were reduced in the presence of supplemental oxygen during simulated hypoventilation and hyperventilation 15 . This is consistent with evidence that ETCO 2 accuracy is more difficult to achieve when the flow rate of CO 2 in exhaled breath is similar to the flow rate of supplemental oxygen, due to dilution of the exhaled CO 2 ( Figure 2B) 20 .…”

Section: Introductionsupporting

confidence: 89%

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Restrepo

Karpenkop

Liu

2020

JoVE

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Capnography is commonly used to monitor patient's ventilatory status. While sidestream capnography has been shown to provide a reliable assessment of end-tidal CO 2 (ETCO 2), its accuracy is commonly validated using commercial kits composed of a capnography monitor and its matching disposable nasal cannula sampling lines. The purpose of this study was to assess the compatibility and accuracy of cross-paired capnography sampling lines with a single portable bedside capnography monitor. A series of 4 bench tests were performed to evaluate the tensile strength, rise time, ETCO 2 accuracy as a function of respiratory rate, and ETCO 2 accuracy in the presence of supplemental O 2. Each bench test was performed using specialized, validated equipment to allow for a full evaluation of sampling line performance. The 4 bench tests successfully differentiated between sampling lines from different commercial sources and suggested that due to increased rise time and decreased ETCO 2 accuracy, not all nasal cannula sampling lines provide reliable clinical data when cross-paired with a commercial capnography monitor. Care should be taken to ensure that any cross-pairing of capnography monitors and disposable sampling lines is fully validated for use across respiratory rates and supplemental O 2 flow rates commonly encountered in clinical settings.

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Section: Introductionsupporting

confidence: 89%

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Restrepo

Karpenkop

Liu

2020

JoVE

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“…The present study found that RR and HR are important parameters to explain Frontiers in Physiology frontiersin.org the CBF variations in a typical, hour-long MRI experiment. The reason that RR and HR can explain CBF variance may be: (a) activities of medullary neurons, which mediates breathing and cardiac rate (Salo et al, 2009), were dynamically affected by isoflurane; therefore heart rate and respiration rate are indirect markers for isoflurane concentration; (b) respiration rate is associated with end-tidal CO 2 level (Takaki et al, 2017), which has a well-known effect on CBF. Note that it is technically challenging to measure end-tidal CO 2 directly in mice without invasive procedures.…”

Section: Resultsmentioning

confidence: 99%

Toward accurate cerebral blood flow estimation in mice after accounting for anesthesia

Wei

Bibic

et al. 2023

Front. Physiol.

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Purpose: To improve the accuracy of cerebral blood flow (CBF) measurement in mice by accounting for the anesthesia effects.Methods: The dependence of CBF on anesthesia dose and time was investigated by simultaneously measuring respiration rate (RR) and heart rate (HR) under four different anesthetic regimens. Quantitative CBF was measured by a phase-contrast (PC) MRI technique. RR was evaluated with a mouse monitoring system (MouseOX) while HR was determined using an ultrashort-TE MRI sequence. CBF, RR, and HR were recorded dynamically with a temporal resolution of 1 min in a total of 19 mice. Linear regression models were used to investigate the relationships among CBF, anesthesia dose, RR, and HR.Results: CBF, RR, and HR all showed a significant dependence on anesthesia dose (p < 0.0001). However, the dose in itself was insufficient to account for the variations in physiological parameters, in that they showed a time-dependent change even for a constant dose. RR and HR together can explain 52.6% of the variations in CBF measurements, which is greater than the amount of variance explained by anesthesia dose (32.4%). Based on the multi-parametric regression results, a model was proposed to correct the anesthesia effects in mouse CBF measurements, specifically CBFcorrected=CBF+0.58RR−0.41HR−32.66Dose. We also reported awake-state CBF in mice to be 142.0 ± 8.8 mL/100 g/min, which is consistent with the model-predicted value.Conclusion: The accuracy of CBF measurement in mice can be improved by using a correction model that accounts for respiration rate, heart rate, and anesthesia dose.

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Predicting sepsis at emergency department triage: Implementing clinical and laboratory markers within the first nursing assessment to enhance diagnostic accuracy

Sisto,

Di Bella,

Porta

et al. 2024

J of Nursing Scholarship

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BackgroundEarly identification of sepsis in the emergency department (ED) triage is both valuable and challenging. Numerous studies have endeavored to pinpoint clinical and biochemical criteria to assist clinicians in the prompt diagnosis of sepsis, but few studies have assessed the efficacy of these criteria in the ED triage setting. The aim of the study was to explore the accuracy of clinical and laboratory markers evaluated at the triage level in identifying patients with sepsis.MethodsA prospective study was conducted in a large academic urban hospital, implementing a triage protocol aimed at early identification of septic patients based on clinical and laboratory markers. A multidisciplinary panel of experts reviewed cases to ensure accurate identification of septic patients. Variables analyzed included: Charlson comorbidity index, mean arterial pressure (MAP), partial pressure of carbon dioxide (PetCO2), white cell count, eosinophil count, C‐reactive protein to albumin ratio, procalcitonin, and lactate.ResultsA total of 235 patients were included. Multivariable analysis identified procalcitonin ≥1 ng/mL (OR 5.2; p < 0.001); CRP‐to‐albumin ratio ≥32 (OR 6.6; p < 0.001); PetCO2 ≤ 28 mmHg (OR 2.7; p = 0.031), and MAP <85 mmHg (OR 7.5; p < 0.001) as independent predictors for sepsis. MAP ≥85 mmHg, CRP/albumin ratio <32, and procalcitonin <1 ng/mL demonstrated negative predictive values for sepsis of 90%, 89%, and 88%, respectively.ConclusionsOur study underscores the significance of procalcitonin and mean arterial pressure, while introducing CRP/albumin ratio and PetCO2 as important variables to consider in the very initial assessment of patients with suspected sepsis in the ED.Clinical Relevance Early identification of sepsis since the emergency department (ED) triage is challenging Implementing the ED triage protocol with simple clinical and laboratory markers allows to recognize patients with sepsis with a very good discriminatory power (AUC 0.88)

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Deep Breathing Improves End-Tidal Carbon Dioxide Monitoring of an Oxygen Nasal Cannula-Based Capnometry Device in Subjects Extubated After Abdominal Surgery

Abstract: P measurements under deep breathing with mouth closed with a capnometry-type oxygen cannula improved the prediction of the absolute value of P in extubated post-abdominal surgical subjects without respiratory dysfunction.

Cited by 3 publications

References 20 publications

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Evaluation of Capnography Sampling Line Compatibility and Accuracy when Used with a Portable Capnography Monitor

Toward accurate cerebral blood flow estimation in mice after accounting for anesthesia

Predicting sepsis at emergency department triage: Implementing clinical and laboratory markers within the first nursing assessment to enhance diagnostic accuracy

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