scholarly journals Arterial and end‐tidal carbon dioxide partial pressure difference during prehospital anaesthesia in critically ill patients

2020 ◽  
Author(s):  
Heini Harve‐Rytsälä ◽  
Susanne Ångerman ◽  
Hetti Kirves ◽  
Jouni Nurmi
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Difference ◽  
Carbon Dioxide Partial Pressure ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

scholarly journals The Use of Catheter Mount Will Result in More Reliable Carbon Dioxide Monitoring under Fluid Exposing Conditions

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yongil Cho ◽  
Wonhee Kim ◽  
Tae Ho Lim ◽  
Hyuk Joong Choi ◽  
Jaehoon Oh ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Crossover Study ◽  
Endotracheal Tube ◽  
Correlation Coefficient ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Open Label ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Monitoring ◽  
End Tidal

Introduction. Capnometer can be readily malfunctioned by fluid exposure during treatment of critically ill patients. This study aimed to determine whether placing capnometer distant from the endotracheal tube by connecting direct connect catheter mount (DCCM) is effective in yielding reliable end-tidal carbon dioxide (ETCO2) by reducing capnometer malfunctioning caused by water exposure. Methods. In 25 healthy adults, a prospective, open label, crossover study was conducted to examine the effect of DCCM in mainstream and microstream capnometers under water exposing conditions. The primary endpoint was the comparison of ETCO2 between proximal DCCM (pDCCM) and distal DCCM (dDCCM). Results. For mainstream capnometers, mean ETCO2 was significantly (p < 0.001) higher in dDCCM compared to pDCCM under water exposing conditions (29.5 vs. 19.0 with 5 ml; 33.8 vs. 21.2 with 10 ml; mmHg). Likewise, for microstream capnometers, ETCO2 was greatly higher (p < 0.001) in dDCCM compared to pDCCM (30.5 vs. 13.9 with 5 ml; 29.9 vs.11.4 with 10 mL; mmHg). ETCO2 measured by dDCCM was reliable in microstream settings, whereas it was unreliable in mainstream (correlation coefficient 0.88 vs. 0.27). Conclusions. Application of DCCM onto the capnometer setting seems to be effective in reducing capnometer malfunctioning under fluid exposing conditions, which is obvious in microstream capnometer by producing more reliable ETCO2.

Only Carbon Dioxide Absorbents Free of Both NaOH and KOH Do Not Generate Compound A during In Vitro  Closed-system Sevoflurane

2001 ◽  
Vol 95 (3) ◽  
pp. 750-755 ◽  
Author(s):  
Linda F. M. Versichelen ◽  
Marie-Paule L. A. Bouche ◽  
Georges Rolly ◽  
Jan F. P. Van Bocxlaer ◽  
Michel M. R. F. Struys ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Closed System ◽  
Breathing Circuit ◽  
Lithium Hydroxide ◽  
Lung Model ◽  
Carbon Dioxide Partial Pressure ◽  
Compound A ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

Background Insufficient data exist on the production of compound A during closed-system sevoflurane administration with newer carbon dioxide absorbents. Methods A modified PhysioFlex apparatus (Dräger, Lübeck, Germany) was connected to an artificial test lung (inflow at the top of the bellow approximately/= 160 ml/min CO2; outflow at the Y piece of the lung model approximately/= 200 ml/min, simulating oxygen consumption). Ventilation was set to obtain an end-tidal carbon dioxide partial pressure of approximately 40 mmHg. Various fresh carbon dioxide absorbents were used: Sodasorb (n = 6), Sofnolime (n = 6), and potassium hydroxide (KOH)-free Sodasorb (n = 7), Amsorb (n = 7), and lithium hydroxide (n = 7). After baseline analysis, liquid sevoflurane was injected into the circuit by syringe pump to obtain 2.1% end-tidal concentration for 240 min. At baseline and at regular intervals thereafter, end-tidal carbon dioxide partial pressure, end-tidal sevoflurane concentration, and canister inflow (T degrees(in)) and canister outflow (T degrees(out)) temperatures were measured. To measure compound Ainsp concentration in the inspired gas of the breathing circuit, 2-ml gas samples were taken and analyzed by capillary gas chromatography plus mass spectrometry. Results The median (minimum-maximum) highest compound Ainsp concentrations over the entire period were, in decreasing order: 38.3 (28.4-44.2)* (Sofnolime), 30.1 (23.9-43.7) (KOH-free Sodasorb), 23.3 (20.0-29.2) (Sodasorb), 1.6 (1.3-2.1)* (lithium hydroxide), and 1.3 (1.1-1.8)* (Amsorb) parts per million (*P &lt; 0.01 vs. Sodasorb). After reaching their peak concentration, a decrease for Sofnolime, KOH-free Sodasorb, and Sodasorb until 240 min was found. The median (minimum-maximum) highest values for T degrees(out) were 39 (38-40), 40 (39-42), 41 (40-42), 46 (44-48)*, and 39 (38-41) degrees C (*P &lt; 0.01 vs. Sodasorb), respectively. Conclusions With KOH-free (but sodium hydroxide [NaOH]-containing) soda limes even higher compound A concentrations are recorded than with standard Sodasorb. Only by eliminating KOH as well as NaOH from the absorbent (Amsorb and lithium hydroxide) is no compound A produced.

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