Capnography for monitoring non-intubated spontaneously breathing patients in an emergency room setting.

Egleston, C V; Aslam, Hina; Lambert, Margareta

doi:10.1136/emj.14.4.222

Cited by 32 publications

(18 citation statements)

References 3 publications

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“…Respiratory rate is out of step with the other vital signs, which are measured electronically. There is a long list of proposed alternatives: capnography by mask, nasal prongs, or mouthpiece [30][31][32] ; pneumotachography (direct flow measurement) by mask or mouthpiece 33,34 ; acoustic monitoring by nasal microphones 30,35 ; nasal thermistors (temperature) 18,34,36 ; fiberoptic nasal sensors that gauge condensation during exhalation 30,37,38 ; inductive plethysmography, which measures chest wall and abdominal movement by bands encircling the trunk (extensometry) 26,33 ; single-compartment and multicompartment air mattresses that measure and compare chest and abdominal volumes [39][40][41] ; mask-mounted pyroelectric polymer strips, which detect temperature variations 32,42 ; transdermal fiberoptic photoplethysmography 30,43,44 ; and transthoracic impedance plethysmography. 13,18,26,30,32,37,[45][46][47] All of the above-mentioned modalities have been reported to correlate well with ''criterion standard'' clinical measurement of respiratory rate.…”

Section: Discussionmentioning

confidence: 99%

The vexatious vital: Neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage

Lovett

Buchwald

Sturmann

et al. 2005

Annals of Emergency Medicine

210

168

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Section: Discussionmentioning

confidence: 99%

The vexatious vital: Neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage

Lovett

Buchwald

Sturmann

et al. 2005

Annals of Emergency Medicine

210

168

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“…Later studies largely focused on isolated evaluation of various numerical parameters and indices describing capnogram shape [5], [6].…”

Section: Introductionmentioning

confidence: 99%

Automated Quantitative Analysis of Capnogram Shape for COPD–Normal and COPD–CHF Classification

Mieloszyk

Verghese

Deitch

et al. 2014

IEEE Trans. Biomed. Eng.

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Abstract-We develop an approach to quantitative analysis of carbon dioxide concentration in exhaled breath, recorded as a function of time by capnography. The generated waveform -or capnogram -is currently used in clinical practice to establish the presence of respiration as well as determine respiratory rate and end-tidal CO 2 concentration. The capnogram shape also has diagnostic value, but is presently assessed qualitatively, by visual inspection. Prior approaches to quantitatively characterizing the capnogram shape have explored the correlation of various geometric parameters with pulmonary function tests. These studies attempted to characterize the capnogram in normal subjects and patients with cardiopulmonary disease, but no consistent progress was made, and no translation into clinical practice was achieved. We apply automated quantitative analysis to discriminate between chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF), and between COPD and normal. Capnograms were collected from 30 normal subjects, 56 COPD patients, and 53 CHF patients. We computationally extract four physiologically based capnogram features. Classification on a hold-out test set was performed by an ensemble of classifiers employing quadratic discriminant analysis, designed through cross-validation on a labeled training set. Using 80 exhalations of each capnogram record in the test set, performance analysis with bootstrapping yields areas under the Index Terms-Capnography, classification, ensemble learning, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF).

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“…Whereas gross changes are visible to the naked eye, for example, "shark fin" appearance, more subtle changes require measurement of the slopes and angles. Because this is still a new concept, in all studies to date, this has been done manually (4,10,11). We have taken a slightly different approach.…”

Section: End-tidal Capnographymentioning

confidence: 99%

The Use of End-Tidal Capnography to Monitor Non-Intubated Patients Presenting with Acute Exacerbation of Asthma in the Emergency Department

Howe

Jaalam

Ahmad

et al. 2011

The Journal of Emergency Medicine

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e Abstract-Study Objective: To determine if the slope of Phase II and Phase III, and the alpha angle of the expiratory capnographic waveform, as measured via computerrecognizable algorithms, can reflect changes in bronchospasm in acute asthmatic non-intubated patients presenting to the emergency department (ED). Methods: In this prospective study carried out in a university hospital ED, 30 patients with acute asthma were monitored with clinical severity scoring and peak flow measurements, and then had a nasal cannula attached for sidestream sampling of expired carbon dioxide. The capnographic waveform was recorded onto a personal computer card for analysis. The patients were treated according to departmental protocols. After treatment, when they had improved enough for discharge, a second set of results was obtained for capnographic waveform recording. The pre-treatment and posttreatment results were then compared with paired-samples t-test analysis. Results: On the capnographic waveform preand post-treatment, there was a significant difference in the slope of Phase III (p < 0.001) and alpha angle (p < 0.001), but not in the Phase II slope (p ‫؍‬ 0.35). There was significant change in peak flow meter reading, but it was poorly correlated with all the capnographic indices. Conclusion: The study provides some preliminary data showing that capnographic waveform indices can indicate improvement in airway diameter in acute asthmatics in the ED. Capnographic waveform analysis presents several advantages in that it is effort-independent, and provides continuous monitoring of normal tidal respiration. With further refined studies, it may serve as a new method of monitoring nonintubated asthmatics in the ED.

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Capnography for monitoring non-intubated spontaneously breathing patients in an emergency room setting.

Cited by 32 publications

References 3 publications

The vexatious vital: Neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage

The vexatious vital: Neither clinical measurements by nurses nor an electronic monitor provides accurate measurements of respiratory rate in triage

Automated Quantitative Analysis of Capnogram Shape for COPD–Normal and COPD–CHF Classification

The Use of End-Tidal Capnography to Monitor Non-Intubated Patients Presenting with Acute Exacerbation of Asthma in the Emergency Department

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