O-29 End-tidal carbon dioxide is a reliable non-invasive parameter in acute pulmonary embolism

2011 ◽  
Vol 25 (3) ◽  
pp. S13
Author(s):  
Bodil Steen Rasmussen ◽  
Søren Risom Kristensen ◽  
Susanne de Neergaard ◽  
Benedict Kjaergaard
Keyword(s):  
Carbon Dioxide ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
O 29 ◽  
Non Invasive ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

Effectiveness of end-tidal carbon dioxide tension for monitoring of thrombolytic therapy in acute pulmonary embolism

2000 ◽  
Vol 28 (11) ◽  
pp. 3588-3592 ◽  
Author(s):  
Uwe K. H. Wiegand ◽  
Volkhard Kurowski ◽  
Evangelos Giannitsis ◽  
Hugo A. Katus ◽  
Hasib Djonlagic
Keyword(s):  
Carbon Dioxide ◽  
Pulmonary Embolism ◽  
Thrombolytic Therapy ◽  
Acute Pulmonary Embolism ◽  
Carbon Dioxide Tension ◽  
End Tidal Carbon Dioxide ◽  
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.

Excluding Pulmonary Embolism with End-tidal Carbon Dioxide: Accuracy, Cost, and Harm Avoidance

2020 ◽  
Vol 42 (12) ◽  
pp. 1022-1030
Author(s):  
Donna Prentice ◽  
Chelsea B. Deroche ◽  
Deidre D. Wipke-Tevis
Keyword(s):  
Carbon Dioxide ◽  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pulmonary Angiography ◽  
Harm Avoidance ◽  
Diagnostic Process ◽  
Intravenous Contrast ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

A non-randomized single center prospective, descriptive, correlational design was used to determine what end-tidal carbon dioxide (EtCO2) level provided the best sensitivity, specificity, and negative predictive value to exclude pulmonary embolism (PE) diagnosis in hemodynamically stable hospitalized adults ( n = 111). The financial impact and harm avoidance of adding EtCO2 to the PE diagnostic process also were examined. PE diagnosis was determined by computed tomography pulmonary angiography (CTPA). PE prevalence was 18.9%. Mean±SD EtCO2 was lower for PE positive than negative participants (28 ± 7.8 to 33 ± 8.1 mmHg respectively 95% CI: 1.22–8.96; P = .01). For PE exclusion, an EtCO2 cutoff ≥42 mmHg yielded 100% sensitivity, 12.2% specificity, and 100% negative predictive value. For every six inpatients assessed with EtCO2, one could be saved from unnecessary CTPA. Eliminating unnecessary CTPA removes the potential harm associated with radiation and intravenous contrast exposure. Additionally, an EtCO2 cutoff ≥42 mmHg could eliminate ~$88,000/year in healthcare waste at this institution.

Utilizing End-Tidal Carbon Dioxide to Diagnose Diabetic Ketoacidosis in Prehospital Patients with Hyperglycemia

2020 ◽  
Vol 35 (3) ◽  
pp. 281-284
Author(s):  
Christopher Hunter ◽  
Monty Putman ◽  
Jermaine Foster ◽  
Amy Souers ◽  
Alexa Rodriguez ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Diabetic Ketoacidosis ◽  
Correlation Coefficient ◽  
Vital Signs ◽  
Operating Characteristics ◽  
Non Invasive ◽  
End Tidal Carbon Dioxide ◽  
The Mean ◽  
One Year ◽  
End Tidal

AbstractBackground:Early identification of diabetic ketoacidosis (DKA) may improve clinical outcomes. Prior studies suggest exhaled end tidal carbon dioxide (ETCO2) provides a non-invasive, real-time method to screen for DKA in the emergency department (ED).Methods:This a retrospective cohort study among patients who activated Emergency Medical Services (EMS) during a one-year period. Initial out-of-hospital vital signs documented by EMS personnel, including ETCO2 and first recorded blood glucose level (BGL), as well as in-hospital records, including laboratory values and diagnosis, were collected. The main outcome was the association between ETCO2 and the diagnosis of DKA.Results:Of the 118 patients transported with hyperglycemia (defined by BGL >200), six (5%) were diagnosed with DKA. The mean level of ETCO2 in those without DKA was 35mmHg (95% CI, 33-38mmHg) compared to mean levels of 15mmHg (95% CI, 8-21mmHg) in those with DKA (P <.001). The Area Under the Receiver Operating Characteristics (ROC) Curve (AUC) for ETCO2 identifying DKA was 0.96 (95% CI, 0.92-1.00). The correlation coefficient between ETCO2 and serum bicarbonate (HCO3) was 0.436 (P <.001) and the correlation coefficient between ETCO2 and anion gap was -0.397 (P <.001).Conclusion:Among patients with hyperglycemia, prehospital levels of ETCO2 were significantly lower in patients with DKA compared to those without and were predictive of the diagnosis of DKA. Furthermore, out-of-hospital ETCO2 was significantly correlated with measures of metabolic acidosis.

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