The global capnography gap: a call to action

Lipnick, Michael S; Mavoungou, P.; Gelb, Adrian W.

doi:10.1111/anae.14478

Cited by 15 publications

(20 citation statements)

References 15 publications

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“…67 Any attempt to increase capnography availability in LMICs should carefully consider these barriers to easy adoption. 18,67…”

Section: Discussionmentioning

confidence: 99%

“…Finally, almost all of the included studies were from HICs, limiting their generalisability to LMICs, where capnography could be disproportionately valuable (Fig 3). 18…”

Section: Limitationsmentioning

confidence: 99%

“…17 Increasing capnography availability in LMICs has been highlighted as a potential priority for improving safe anaesthesia practice globally. 18 .…”

mentioning

confidence: 99%

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Impact of capnography on patient safety in high- and low-income settings: a scoping review

Wollner

Nourian

Booth

et al. 2020

British Journal of Anaesthesia

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Background: Capnography is universally accepted as an essential patient safety monitor in high-income countries (HICs) yet is often unavailable in low and middle-income countries (LMICs). Increasing capnography availability has been proposed as one of many potential approaches to improving perioperative outcomes in LMICs. This scoping review summarises the existing literature on the effect of capnography on patient outcomes to help prioritise interventions and guide expansion of capnography in LMICs. Methods: We searched MEDLINE and EMBASE databases for articles published between 1980 and March 2019. Studies that assessed the impact of capnography on morbidity, mortality, or the use of airway interventions both inside and outside the operating room were included. Results: The search resulted in 7445 unique papers, and 31 were included for analysis. Retrospective and nonrandomised data suggest capnography use may improve outcomes in the operating room, ICU, and emergency department, and during resuscitation. Prospective data on capnography use for procedural sedation suggest earlier detection of hypoventilation and a reduction in haemoglobin desaturation events. No randomised studies exist that assess the impact of capnography on patient outcomes. Conclusion: Despite widespread endorsement of capnography as a mandatory perioperative monitor, rigorous data demonstrating its impact on patient outcomes are limited, especially in LMICs. The association between capnography use and a reduction in serious airway complications suggests that closing the capnography gap in LMICs may represent a significant opportunity to improve patient safety. Additional data are needed to quantify the global capnography gap and better understand the barriers to capnography scale-up in LMICs.

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“…67 Any attempt to increase capnography availability in LMICs should carefully consider these barriers to easy adoption. 18,67…”

Section: Discussionmentioning

confidence: 99%

“…Finally, almost all of the included studies were from HICs, limiting their generalisability to LMICs, where capnography could be disproportionately valuable (Fig 3). 18…”

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Impact of capnography on patient safety in high- and low-income settings: a scoping review

Wollner

Nourian

Booth

et al. 2020

British Journal of Anaesthesia

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show abstract

“…Capnography is arguably as essential for safe anaesthesia as oximetry, but to date, the monitors have been both more expensive and less robust. 12 A recent project in Malawi has demonstrated that introduction of capnography is feasible in at least some low-resource environments, 13 and the Standards add 'Equipment manufacturers are encouraged to urgently address this deficiency'.…”

Section: International Standards For a Safe Practice Of Anaesthesiamentioning

confidence: 99%

Global health and anaesthesia: An exciting time

Cooper

Morriss

Stone

et al. 2019

Anaesth Intensive Care

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“…In addition, pulse oximetry provides relatively late warning of airway complications (hypoxia) from obstruction or misplaced airway. [24] Implementation of capnography has had some early success—introduction of capnographs in Malawi resulted in increased knowledge about capnography, with most providers reporting recognition of oesophageal intubation and belief that capnography had saved lives. The authors estimated that there are approximately 11,000 deaths per year in Sub-Saharan Africa from oesophageal intubations.…”

Section: Introductionmentioning

confidence: 99%

The path to safe and accessible anaesthesia care

et al. 2019

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The increasing focus on and importance of surgical care in achieving universal health coverage requires the development of safe and accessible anaesthesia services. Increasing access to care by supporting the necessary inputs to the anaesthesia system, including medications, equipment and personnel, must be accompanied by processes that support high-quality care, including support for education, and guidelines for standards, and training. As safe, high-quality care requires an integrated approach, each element must be supported together, i.e., in an integrated manner to ensure that anaesthesia care reaches those who need it, and in the safest possible manner. Several important efforts have been undertaken globally to address and foster these elements, and resources to guide these processes exist for low- and middle-income countries to improve them. This review highlights both the needs and resources for safe and high-quality care that patients deserve.

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The global capnography gap: a call to action

Cited by 15 publications

References 15 publications

Impact of capnography on patient safety in high- and low-income settings: a scoping review

Impact of capnography on patient safety in high- and low-income settings: a scoping review

Global health and anaesthesia: An exciting time

The path to safe and accessible anaesthesia care

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