scholarly journals Investigation of the relationship between end-tidal carbon dioxide and partial arterial carbon dioxide pressure in patients with respiratory distress

2020 ◽  
Author(s):  
Gholamreza Masoumi ◽  
Amir Noyani ◽  
Arezoo Dehghani ◽  
Ali Afrasiabi ◽  
Nahid Kianmehr
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Distress ◽  
Arterial Carbon Dioxide ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Pressure ◽  
End Tidal ◽  
The Relationship

Exercise end-tidal carbon dioxide pressure: a new prognostic marker after acute myocardial infarction?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Ferreira ◽  
P Rio ◽  
A Castelo ◽  
I Cardoso ◽  
S Silva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Carbon Dioxide ◽  
Acute Myocardial Infarction ◽  
Prognostic Marker ◽  
Systolic Function ◽  
Prognostic Role ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Pressure ◽  
End Tidal ◽  
Maximal Effort

Abstract Funding Acknowledgements Type of funding sources: None. Background Although several cardiopulmonary exercise testing (CPET) parameters have already proved to predict prognosis, there is increasing interest in finding variables that do not require maximal effort. End-tidal carbon dioxide pressure (PETCO2), an indirect indicator of cardiac output, is one of such variables. Studies in heart failure populations already suggest its role as a prognostic factor. However, data concerning other populations are still scarce. Purpose To assess the association between exercise PETCO2, cardiac biomarkers and systolic function following acute myocardial infarction (AMI) and to evaluate its potential prognostic role in this population. Methods A retrospective single-centre analysis was conducted including patients who underwent symptom-limited CPET early after AMI. We assessed PETCO2 at baseline (PETCO2-B), at anaerobic threshold (PETCO2-AT) and at peak exercise and calculated the difference between PETCO2-AT and PETCO2-B (PETCO2-difference). We analysed their association with B-natriuretic peptide (BNP), maximal troponin after AMI as well as with left ventricular ejection fraction (LVEF) 1 year after. Results We included 40 patients with a mean age of 56 years (87.5% male), assessed with CPET a median of 3 months after AMI (80% of which were ST-elevation myocardial infarctions). Average respiratory exchange ratio was 1,1 with 48% of patients not reaching maximal effort. Mean PETCO2-AT was 37mmHg, with a mean increase from baseline of 6mmHg (PETCO2-difference). There was a significant positive correlation between all the PETCO2 variables measured and BNP values at time of AMI and on follow-up (best correlation for PETCO2-AT with BNP at AMI hospitalization, r = 0.608, p < 0.001). Maximal troponin was not correlated with PETCO2. Both PETCO2-AT and PETCO2-difference were significantly and positively correlated with LVEF 1-year post-AMI (r = 0.421, p = 0.040 and r = 0.511, p = 0.011, respectively). Conclusion PETCO2-AT and PETCO2-difference are both correlated with BNP, an established prognostic marker, and with medium-term systolic function after AMI, suggesting their potential prognostic role in this population. Further studies with larger samples are required to confirm the results of this pilot study and assess PETCO2 as a definite predictor of prognosis after AMI.

scholarly journals Accuracy of Postoperative End-tidal Pco2Measurements with Mainstream and Sidestream Capnography in Non-obese Patients and in Obese Patients with and without Obstructive Sleep Apnea

2009 ◽  
Vol 111 (3) ◽  
pp. 609-615 ◽  
Author(s):  
Yusuke Kasuya ◽  
Ozan Akça ◽  
Daniel I. Sessler ◽  
Makoto Ozaki ◽  
Ryu Komatsu
Keyword(s):  
Carbon Dioxide ◽  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Cannula ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Pressure ◽  
End Tidal

Background Obtaining accurate end-tidal carbon dioxide pressure measurements via nasal cannula poses difficulties in postanesthesia patients who are mouth breathers, including those who are obese and those with obstructive sleep apnea (OSA); a nasal cannula with an oral guide may improve measurement accuracy in these patients. The authors evaluated the accuracy of a mainstream capnometer with an oral guide nasal cannula and a sidestream capnometer with a nasal cannula that did or did not incorporate an oral guide in spontaneously breathing non-obese patients and obese patients with and without OSA during recovery from general anesthesia. Methods The study enrolled 20 non-obese patients (body mass index less than 30 kg/m) without OSA, 20 obese patients (body mass index greater than 35 kg/m) without OSA, and 20 obese patients with OSA. End-tidal carbon dioxide pressure was measured by using three capnometer/cannula combinations (oxygen at 4 l/min): (1) a mainstream capnometer with oral guide nasal cannula, (2) a sidestream capnometer with a nasal cannula that included an oral guide, and (3) a sidestream capnometer with a standard nasal cannula. Arterial carbon dioxide partial pressure was determined simultaneously. The major outcome was the arterial-to-end-tidal partial pressure difference with each combination. Results In non-obese patients, arterial-to-end-tidal pressure difference was 3.0 +/- 2.6 (mean +/- SD) mmHg with the mainstream capnometer, 4.9 +/- 2.3 mmHg with the sidestream capnometer and oral guide cannula, and 7.1 +/- 3.5 mmHg with the sidestream capnometer and a standard cannula (P < 0.05). In obese non-OSA patients, it was 3.9 +/- 2.6 mmHg, 6.4 +/- 3.1 mmHg, and 8.1 +/- 5.0 mmHg, respectively (P < 0.05). In obese OSA patients, it was 4.0 +/- 3.1 mmHg, 6.3 +/- 3.2 mmHg, and 8.3 +/- 4.6 mmHg, respectively (P < 0.05). Conclusions Mainstream capnometry performed best, and an oral guide improved the performance of sidestream capnometry. Accuracy in non-obese and obese patients, with and without OSA, was similar.

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