Use of end-tidal carbon dioxide detection to determine correct placement of nasogastric tube: A meta-analysis

2011 ◽  
Vol 48 (4) ◽  
pp. 513-521 ◽  
Author(s):  
Janita P.C. Chau ◽  
Suzanne H.S. Lo ◽  
David R. Thompson ◽  
Ritin Fernandez ◽  
Rhonda Griffiths
Keyword(s):  
Carbon Dioxide ◽  
Nasogastric Tube ◽  
Meta Analysis ◽  
Correct Placement ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Detection ◽  
End Tidal

scholarly journals Value of variation of end-tidal carbon dioxide for predicting fluid responsiveness during the passive leg raising test in patients with mechanical ventilation: a systematic review and meta-analysis

Critical Care ◽  
2022 ◽  
Vol 26 (1) ◽  
Author(s):  
Haijun Huang ◽  
Chenxia Wu ◽  
Qinkang Shen ◽  
Yixin Fang ◽  
Hua Xu
Keyword(s):  
Carbon Dioxide ◽  
Mechanical Ventilation ◽  
Sensitivity Analysis ◽  
Fluid Responsiveness ◽  
Meta Analysis ◽  
End Tidal Carbon Dioxide ◽  
Study Heterogeneity ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
End Tidal

Abstract Background The ability of end-tidal carbon dioxide (ΔEtCO2) for predicting fluid responsiveness has been extensively studied with conflicting results. This meta-analysis aimed to explore the value of ΔEtCO2 for predicting fluid responsiveness during the passive leg raising (PLR) test in patients with mechanical ventilation. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched up to November 2021. The diagnostic odds ratio (DOR), sensitivity, and specificity were calculated. The summary receiver operating characteristic curve was estimated, and the area under the curve (AUROC) was calculated. Q test and I2 statistics were used for study heterogeneity and publication bias was assessed by Deeks’ funnel plot asymmetry test. We performed meta-regression analysis for heterogeneity exploration and sensitivity analysis for the publication bias. Results Overall, six studies including 298 patients were included in this review, of whom 149 (50%) were fluid responsive. The cutoff values of ΔEtCO2 in four studies was 5%, one was 5.8% and the other one was an absolute increase 2 mmHg. Heterogeneity between studies was assessed with an overall Q = 4.098, I2 = 51%, and P = 0.064. The pooled sensitivity and specificity for the overall population were 0.79 (95% CI 0.72–0.85) and 0.90 (95% CI 0.77–0.96), respectively. The DOR was 35 (95% CI 12–107). The pooled AUROC was 0.81 (95% CI 0.77–0.84). On meta-regression analysis, the number of patients was sources of heterogeneity. The sensitivity analysis showed that the pooled DOR ranged from 21 to 140 and the pooled AUC ranged from 0.92 to 0.96 when one study was omitted. Conclusions Though the limited number of studies included and study heterogeneity, our meta-analysis confirmed that the ΔEtCO2 performed moderately in predicting fluid responsiveness during the PLR test in patients with mechanical ventilation.

scholarly journals Value of Variation of End-Tidal Carbon Dioxide for Predicting Fluid Responsiveness During the Passive Leg Raising Test in Patients with Mechanical Ventilation: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Haijun Huang ◽  
Chenxia Wu ◽  
Qinkang Shen ◽  
Yixin Fang ◽  
Hua Xu
Keyword(s):  
Carbon Dioxide ◽  
Mechanical Ventilation ◽  
Sensitivity Analysis ◽  
Regression Analysis ◽  
Fluid Responsiveness ◽  
Meta Analysis ◽  
End Tidal Carbon Dioxide ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
End Tidal

Abstract Background: The variation of end-tidal carbon dioxide(ΔEtCO2) has have been extensively studied with respect to its value in predicting fluid responsiveness, but the results are conflicting. This meta-analysis aimed to explore the value of ΔEtCO2 for predicting fluid responsiveness during the passive leg raising(PLR) test in patients with mechanical ventilation. Methods: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched up to November 2021. The diagnostic odds ratio (DOR), sensitivity, and specificity were calculated. The summary receiver operating characteristic curve was estimated, and the area under the curve (AUROC) was calculated. We performed meta-regression analysis for heterogeneity exploration and sensitivity analysis for the publication bias.Results: Overall, 298 patients were included in this review, of whom 149 (50%) were fluid responsive. The cutoff values of ΔEtCO2 varied across studies, ranging from 5% to 5.8% or absolute increase 2mmHg. Heterogeneity between studies was assessed with an overall Q = 4.098, I2 = 51%, and P = 0.064. The pooled sensitivity and specificity for the overall population were 0.79 (95% CI: 0.72–0.85) and 0.90 (95% CI: 0.77–0.96), respectively. The DOR was 35 (95% CI: 12–107) (Fig. 4). The pooled AUROC was 0.81 (95% CI: 0.77–0.84). On meta-regression analysis, the number of patients was sources of heterogeneity. The sensitivity analysis showed that the pooled DOR ranged from 21 to 140 and the pooled AUC ranged from 0.92 to 0.96 when one study was omitted.Conclusions: This study was the first meta-analysis to evaluate the diagnostic accuracy of ΔEtCO2 in predicting fluid responsiveness during PLR test in patients with mechanical ventilation. This study confirmed that the ΔEtCO2 performed well in predicting fluid responsiveness in patients with mechanical ventilation.

End-tidal carbon, dioxide detection in emergency intubation in four groups of patients

1994 ◽  
Vol 12 (6) ◽  
pp. 771-777 ◽  
Author(s):  
Kenneth C. Sanders ◽  
Woodworth B. Clum ◽  
Steve S. Nguyen ◽  
Subramaniam Balasubramaniam
Keyword(s):  
Carbon Dioxide ◽  
Emergency Intubation ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Detection ◽  
End Tidal

Multicenter study of a portable, hand-size, colorimetric end-tidal carbon dioxide detection device

1992 ◽  
Vol 21 (5) ◽  
pp. 518-523 ◽  
Author(s):  
Joseph P Ornato ◽  
Joshua B Shipley ◽  
Edward M Racht ◽  
Corey M Slovis ◽  
Keith D Wrenn ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Multicenter Study ◽  
Hand Size ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Detection ◽  
End Tidal

Carbon Monoxide and Nonquantitative Carbon Dioxide Detection

1996 ◽  
Vol 11 (4) ◽  
pp. 276-279 ◽  
Author(s):  
Georg Petroianu ◽  
Wolfgang Maleck ◽  
Wolfgang Bergler ◽  
Roderich Ruefer
Keyword(s):  
Carbon Dioxide ◽  
Carbon Monoxide ◽  
Endotracheal Tube ◽  
Reliable Method ◽  
Hospital Setting ◽  
Infrared Spectrometry ◽  
End Tidal Carbon Dioxide ◽  
Tube Position ◽  
Carbon Dioxide Detection ◽  
End Tidal

AbstractIntroduction:The capnometric demonstration of end-tidal carbon dioxide (CO2) is a reliable method of differentiating between a correct endotracheal tube position and an accidental misplacement of the tube into the esophagus. Recently, several CO2 detectors have been introduced for monitoring end-tidal CO2 in the “out-of-hospital” setting, where quantitative capnometry with capnography is not yet available.Hypothesis:These devices are not influenced by carbon monoxide (CO) present in lethal concentration.Methods:A heated (37°C) 2.3 L reservoir bag filled one-third full with water (representing the stomach in esophageal misintubation) was machine ventilated (tidal volume: 450 ml; frequency: 16/min) with the following mixtures for three minutes each: 1) 95% O2, 5% CO; 2) 45% O2 5% CO, 50% N2O; and 3) 44% O2 5% CO, 50% N2O, 1% halothane. The presence of end-tidal CO2 was monitored with each of the following devices: 1) MiniCAP™ III CO2 Detector; 2) StatCAP™ CO2 Detector; 3) EasyCAP™ CO2 Detector; PediCAP™ CO2 Detector; and 5) Colibri™ CO2 Detector.Results:In none of the cases was the presence of CO2 signaled by the detector.Conclusion:The presence of 5% CO does not interfere with infrared spectrometry detection (MiniCAP™ and StatCAP™) or chemical detection (EasyCAP™, PediCAP™, and Colibri™) of CO2. The devices can be used safely in patients with CO poisoning for monitoring of endotracheal tube position.

A Randomized Controlled Trial of End-Tidal Carbon Dioxide Detection of Preterm Infants in the Delivery Room

2017 ◽  
Vol 182 ◽  
pp. 74-78.e2 ◽  
Author(s):  
Gavin A. Hawkes ◽  
Daragh Finn ◽  
Mmoloki Kenosi ◽  
Vicki Livingstone ◽  
John M. O'Toole ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Randomized Controlled Trial ◽  
Preterm Infants ◽  
Controlled Trial ◽  
Delivery Room ◽  
Randomized Controlled ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Detection ◽  
End Tidal

scholarly journals A Persistently High End-Tidal Carbon Dioxide Value: Can This Be Spurious?

2019 ◽  
Vol 07 (02) ◽  
pp. 104-106
Author(s):  
Barkha Bindu ◽  
Gyaninder P. Singh ◽  
Varun Jain ◽  
Arvind Chaturvedi
Keyword(s):  
Carbon Dioxide ◽  
Unusual Case ◽  
Clinical Observation ◽  
Standard Of Care ◽  
Non Invasive ◽  
Correct Placement ◽  
Arterial Blood ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Co2 ◽  
End Tidal

AbstractEnd-tidal carbon dioxide (EtCO2) monitoring has now become the standard of care not only during anesthesia but also in intensive care units for patients on mechanical ventilation, emergency department, and pre-hospital settings to confirm and monitor the correct placement of endotracheal tube. It is a non-invasive and continuous method of measuring exhaled carbon dioxide (CO2). Continuous waveform capnography measures EtCO2 and monitors ventilation. EtCO2 often correlates with partial pressure of carbon dioxide in arterial blood (PaCO2) and is a reliable indicator of PaCO2. A rise in EtCO2 often implies increased production of CO2 or decreased excretion (rebreathing, decrease ventilation) of CO2. We report an unusual case where the monitor malfunction per se lead to spuriously increased EtCO2 values without any clinical cause and did not correlate with PaCO2, thereby re-emphasizing that various monitors must always be interpreted in correlation with clinical observation.

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