Noninvasive monitoring of CO2 during polysomnography

Gerdung, Christopher A.; Adeleye, Adetayo; Kirk, Valerie

doi:10.1097/mcp.0000000000000320

Cited by 13 publications

(8 citation statements)

References 27 publications

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“…In some studies, changes in ETCO2 was observed from breath to breath and from the controlled to the spontaneous breathing (Gerdung et al 2016). Therefore, the momentary monitoring is not reliable and the ETCO2 should be monitored continuously during the weaning process.…”

Section: Discussionmentioning

confidence: 99%

“…The readiness of patients for weaning is usually assessed by arterial blood gas (ABG) sampling. ABG is the gold standard for the monitoring of oxygenation and ventilation during the postoperative MV (Gerdung et al 2016). Arterial line cannulation is employed in the operating room and ICU settings to provide easy access for continuous and real-time systemic blood pressure measurements, blood gas analysis, and other laboratory measurements.…”

Section: Trial Registrationmentioning

confidence: 99%

See 1 more Smart Citation

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

Moradian

Beitollahi

Ghiasi

et al. 2021

Preprint

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Background Use of capnography as a non-invasive method during the weaning process for fast track extubation (FTE) is controversial. We conducted the present study to determine whether pulse oximetry and capnography could be utilized as alternatives to arterial blood gas (ABG) measurements in patients under mechanical ventilation (MV) following coronary artery bypass graft (CABG) surgery. Methods In this randomized clinical trial, 70 patients, who were candidates for CABG surgery, were randomly assigned into two equal groups (n = 35); the intervention group and the control group. In the intervention group, the ventilator management and weaning from MV was done using Etco2 from capnography and SpO2 from pulse oximetry. Meanwhile, in the control group, weaning was done based on ABG analysis. The length of intensive care unit (ICU) stay, time to extubation, number of manual ventilator setting changes, and alarms were compared between the groups. Results The end-tidal carbon dioxide (ETCO2) levels in the intervention group were completely similar to the partial pressure of carbon dioxide (PaCo2) in the control group (39.5 ± 3.1 vs. 39.4 ± 4.32, P > 0.05). The mean extubation times were significantly shorter in the intervention group compared to those in the control patients (212.2 ± 80.6 vs. 342.7 ± 110.7, P < 0.001). Moreover, the number of changes in the manual ventilator setting and the number of alarms were lower in the intervention group (P < 0.05). However, the differences in the length of stay in ICU between the two groups were not significant (P = 0.219). Conclusion According to our results, the use of non-invasive monitors, including capnography and pulse oximetry, is emphasized in order to utilize FTE after CABG surgery. Furthermore, it is a safe and valuable monitor that could be a good alternative for ABG in this population. Nevertheless, further studies with larger sample sizes and on different disease states and populations are required to assess the accuracy of our findings. Trial registration: IRCT, IRCT201701016778N6, Registered 3 March 2017, https://www.irct.ir/trial/7192

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Section: Discussionmentioning

confidence: 99%

Section: Trial Registrationmentioning

confidence: 99%

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

Moradian

Beitollahi

Ghiasi

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…11 [8,12] 5 [4,7] Sex (male) There are conflicting opinions regarding the utility of TcCO 2 in the diagnosis of pediatric SDB. Although it is recommended that CO 2 monitoring be considered in all patients undergoing PSG, 21 it has been argued that the measurement only has utility in children with comorbidities. 22 None of the children in the current study had comorbidities and our measures of TcCO 2 correlated poorly with standard PSG indices such as the MOAHI.…”

Section: Discussionmentioning

confidence: 99%

TcCO₂ changes correlate with partial obstruction in children suspected of sleep disordered breathing

D'Souza

Norman

Sullivan

et al. 2020

Pediatric Pulmonology

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Introduction Pediatric sleep disordered breathing (SDB) is characterized by long periods of partial upper airway obstruction (UAO) with low apnea‐hypopnea indices (AHI). By measuring snoring and stertor, Sonomat studies allow quantification of these periods of partial UAO. Aim To determine whether transcutaneous CO2 (TcCO2) levels correlate with increasing levels of partial UAO and to examine patterns of ΔTcCo2 in the transitions from (a) wakefulness to sleep and (b) non‐rapid eye movement (NREM) to rapid eye movement (REM) sleep. Methods This was a retrospective review of sleep studies in seven asymptomatic controls aged 7 to 12 years and 62 symptomatic children with suspected SDB and no comorbidities, aged 2 to 13 years. Both groups underwent overnight polysomnography, including continuous TcCO2, at one of two pediatric hospitals in Sydney. Changes in carbon dioxide levels between wake to NREM (sleep onset) and NREM to REM sleep were evaluated using an all‐night TcCO2 trace time‐linked to a hypnogram. Paired Sonomat recordings were used to quantify periods of UAO in the symptomatic group. Results The ΔTcCO2 at sleep onset was greater in SDB children than controls and ΔTcCO2 with sleep onset correlated with the duration of partial obstruction (r = .60; P < .0001). Children with an increase in TcCO2 from NREM to REM had a higher number of snoring and stertor events compared to those in whom TcCO2 decreased from NREM to REM (91 vs 30 events/h; P = < .0001). Conclusions In children without comorbidities, the measurement of TcCO2 during sleep correlates with indicators of partial obstruction.

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“…The role of CO2 in SDB during pregnancy has been speculated [ [11], [20]], as well as in preeclampsia [11]. CO2 measurements are not routinely measured during adult sleep studies [21], mainly due to lack of simple, robust and noninvasive methods of CO2 monitoring. The reference measurement is partial pressure of the arterial CO2 (PaCO2), which is a reliable measure of ventilation but requires blood samples and is not suitable for sleep studies.…”

Section: Discussionmentioning

confidence: 99%

Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy

et al. 2017

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Noninvasive monitoring of CO2 during polysomnography

Abstract: Given the benefits of CO2 monitoring and the importance of assessing for hypercapnia, noninvasive continuous CO2 monitoring should be considered for all patients undergoing polysomnography.

Cited by 13 publications

References 27 publications

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

TcCO₂ changes correlate with partial obstruction in children suspected of sleep disordered breathing

Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy

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Noninvasive monitoring of CO2 during polysomnography

Abstract: Given the benefits of CO2 monitoring and the importance of assessing for hypercapnia, noninvasive continuous CO2 monitoring should be considered for all patients undergoing polysomnography.

Cited by 13 publications

References 27 publications

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial

TcCO2 changes correlate with partial obstruction in children suspected of sleep disordered breathing

Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy

Contact Info

Product

Resources

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TcCO₂ changes correlate with partial obstruction in children suspected of sleep disordered breathing