A randomized, controlled trial of transcutaneous carbon dioxide monitoring during ERCP

Risk factors for cardiopulmonary events during propofol‐mediated upper endoscopy and colonoscopy

“…However, previous studies with capnography and transcutaneous CO 2 monitoring during traditional sedation for endoscopy found that the occurrence of transient hypoxaemia can indicate alveolar hypoventilation. 33,36 In the case of propofol, its rapid onset coupled with an indication as an anaesthesia induction agent led us to include transient hypoxaemia as a CP event. In fact, when we analysed the procedure-specific occurrence of CP events between MAC and GAP, a statistically significant difference was seen (GAP > MAC) with and without the inclusion of transient hypoxaemia.…”

Combined Pulse Oximetry/Cutaneous Carbon Dioxide Tension Monitoring during Colonoscopies: Pilot Study with a Smart Ear Clip

“…A further detail that may be relevant for the acceptance of the method in daily practice is the reduced onset time as compared to previous studies with traditional PcCO 2 sensors [23]. The onset time is defined as the time from sensor application until equilibration of the skin PcCO 2 and the PcCO 2 in the sensor is achieved.…”

“…The clinical importance of detecting profound hypoventilation occurring in patients undergoing gastrointestinal endoscopy through carbon dioxide retention has been discussed in earlier studies [4, 15, 23, 24]. With the practical recommendation and the increased use of supplemental oxygen to prevent hypoxemia [25], the measurement of carbon dioxide tension seems to be more relevant because hypoventilation is not reflected by pulse oximetry.…”

“…Our results which show a mean PcCO 2 peak increase of 7.6 (SD 3.4) mm Hg with alfentanil/midazolam are well comparable with those (6.8 mm Hg) reported by Freeman et al [15]in 30 patients undergoing colonoscopy who were sedated with fentanyl and/or midazolam. In longer-lasting ERCP procedures with a tendency to deeper sedation even higher mean peak increases have been reported [15, 23]. Miner et al [4]have reported an increase of 9.4 mm Hg in patients administered sedation during painful procedures in emergency departments.…”

“…We can therefore not state if the monitoring of PcCO 2 adds a major additional benefit for patient safety compared with POX alone. Nelson et al [23]found conflicting results with respect to the benefit of PcCO 2 monitoring to guide sedation and to avoid respiratory depression during ERCP. While he could avoid maximal rises of PcCO 2 of more than 40 mm Hg, the occurrence of desaturations below 80% did not differ significantly.…”