Measurement of combined oximetry and cutaneous capnography during flexible bronchoscopy: Fig. 1—

Abstract

The aim of the present study was to assess the feasibility of measuring combined arterial oxygen saturation measured by pulse oximetry (Sp,O 2 ) and cutaneous carbon dioxide tension (Pc,CO 2 ) to monitor ventilation and quantify change in Pc,CO 2 during bronchoscopy.Combined Sp,O 2 and Pc,CO 2 were measured at the ear lobe in 114 patients. In four patients, the ear-clip slipped and they were excluded. In total, 11 patients had artefacts with Sp,O 2 recordings, thus, Sp,O 2 was analysed in 99 patients. Spirometry data were available in 77 patients. Multivariate analysis of covariance and logistic regression were used for statistical analyses.Mean baseline Pc,CO 2 was 4.78¡1.06 kPa (36¡8 mmHg) and mean rise in the Pc,CO 2 during bronchoscopy was 1.26¡0.70 kPa (9.5¡5.3 mmHg), while mean Pc,CO 2 at the end of bronchoscopy was 5.85¡1.19 kPa (44¡9 mmHg) . Baseline Pc,CO 2 and the lowest Sp,O 2 were significantly associated with peak Pc,CO 2 and the change in Pc,CO 2 during bronchoscopy. Risk of significant hypoxaemia (Sp,O 2 f90%) was lower for a higher baseline Sp,O 2 . Peak Pc,CO 2 was directly associated with significant hypoxaemia. There was no significant association in the baseline Pc,CO 2 , peak Pc,CO 2 , baseline Sp,O 2 or the lowest Sp,O 2 comparing patients with and without chronic obstructive pulmonary disease.In conclusion, it is feasible to measure combined pulse oximetry and cutaneous carbon dioxide tension effectively to monitor ventilation during flexible bronchoscopy.

Diagnostic utility and accuracy of rapid on-site evaluation of bronchoscopic brushings

“…Shortening of procedure times can improve theatre/endoscopy efficiency, thereby reducing procedure costs, and will minimise physiologic perturbation known to affect patients undergoing bronchoscopy [19]. While this benefit may be greatest in patients with severe background lung disease, it is worth noting that the magnitude of change in carbon dioxide and pH, following bronchoscopy, does not differ between patients with and without pulmonary disease [20]. Avoiding use of TBLB forceps will also reduce procedural costs through the reduced use of consumables, and through obviating the need for post-TBLB chest radiographs, which is routine at many institutions.…”

Sedation during Flexible Bronchoscopy in Patients with Pre-Existing Respiratory Failure: Midazolam versus Midazolam plus Alfentanil

“…The null hypothesis (H₀) was defined as there being no difference in peak Ptc C O 2 between the two intervention groups. Sample size determination (unpaired t-test, power 0.9, two-sided type I error 0.05) was performed with an estimated SD of 6 mm Hg for the mean difference of Ptc C O 2 , and a difference of at least 10 mm Hg [14] between the two intervention groups. Accordingly, at least 9 subjects were needed in each group for H₀ rejection.…”

Combined Use of Transcutaneous and End-Tidal Measures of Carbon Dioxide to Predict PCO2 during General Anaesthesia in Adults

“…Previous studies [5][6][7] [16][17][18]. Bland-Altman analysis [19] was applied to assess the mean bias and limits of agreement (LOA) (± 2 standard deviation of bias) of PaCO 2 and PtcCO 2 , PaCO 2 and PetCO 2 , PaCO 2 and Pet_ tcCO 2 .…”