Pedi-cap color change precedes a significant increase in heart rate during neonatal resuscitation

Blank, Douglas A; Rich, Wade; Leone, Tina A.; Garey, Donna; Finer, Neil N.

doi:10.1016/j.resuscitation.2014.08.027

Cited by 48 publications

(52 citation statements)

References 25 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both qualitative and quantitative capnography are affected by airway obstruction, mask leaks and pulmonary blood flow. Therefore, measurements of exhaled carbon dioxide need to be interpreted with caution during resuscitation and in the NICU …”

Section: Resultsmentioning

confidence: 99%

“…14 In two studies, compromised neonates with bradycardia at birth who received mask resuscitation demonstrated an increase in exhaled carbon dioxide before their heart rates were restored and their preductal oxygen saturations increased. 10,15 The long-term value of capnography-guided resuscitation is uncertain, as neither quantitative nor qualitative capnography has been shown to improve arterial carbon dioxide levels when compared to just clinical assessment. 11,16,17 Capnography can monitor lung aeration in various clinical settings, including the NICU and during neonatal transport.…”

Section: Key Notesmentioning

confidence: 99%

“…Therefore, measurements of exhaled carbon dioxide need to be interpreted with caution during resuscitation and in the NICU. 15,16…”

Section: Key Notesmentioning

confidence: 99%

See 2 more Smart Citations

Tools to assess lung aeration in neonates with respiratory distress syndrome

et al. 2019

View full text Add to dashboard Cite

Aim Respiratory distress syndrome is a common condition among preterm neonates, and assessing lung aeration assists in diagnosing the disease and helping to guide and monitor treatment. We aimed to identify and analyse the tools available to assess lung aeration in neonates with respiratory distress syndrome. Methods A systematic review and narrative synthesis of studies published between January 1, 2004, and August 26, 2019, were performed using the OVID Medline, PubMed, Embase and Scopus databases. Results A total of 53 relevant papers were retrieved for the narrative synthesis. The main tools used to assess lung aeration were respiratory function monitoring, capnography, chest X‐rays, lung ultrasound, electrical impedance tomography and respiratory inductive plethysmography. This paper discusses the evidence to support the use of these tools, including their advantages and disadvantages, and explores the future of lung aeration assessments within neonatal intensive care units. Conclusion There are currently several promising tools available to assess lung aeration in neonates with respiratory distress syndrome, but they all have their limitations. These tools need to be refined to facilitate convenient and accurate assessments of lung aeration in neonates with respiratory distress syndrome.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Key Notesmentioning

confidence: 99%

See 1 more Smart Citation

Tools to assess lung aeration in neonates with respiratory distress syndrome

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In the clinical setting, the importance of ETCO 2 during resuscitation has been validated in adults by Falk et al (20). A retrospective study involving neonates using Pedi-cap a colorimetric CO 2 detector has reported color change just prior to ROSC neonatal resuscitation (21) which points to the fact that a rise in ETCO 2 regardless of the value can aid in confirming ROSC along with clinical cues without interrupting resuscitation.…”

Section: Discussionmentioning

confidence: 99%

Continuous capnography monitoring during resuscitation in a transitional large mammalian model of asphyxial cardiac arrest

et al. 2017

View full text Add to dashboard Cite

BACKGROUND In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2) or saturations (SpO2) to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n = 21). Lambs were resuscitated as per NRP guidelines. Systolic blood pressure (SBP), carotid and pulmonary blood flows along with ETCO2 and blood gases were continuously monitored. Resuscitation was continued for 20 min or until ROSC (whichever was earlier). Adequate CC was arbitrarily defined as generation of 30 mmHg SBP during resuscitation. ETCO2 thresholds to predict adequacy of CC and detect ROSC were determined. RESULTS Significant relationship between ETCO2 and adequate CC was noted during resuscitation (AUC-0.735, P < 0.01). At ROSC (n = 12), ETCO2 rapidly increased to 57 ± 20 mmHg with a threshold of ≥32 mmHg being 100% sensitive and 97% specific to predict ROSC. CONCLUSION In a large mammalian model of perinatal asphyxia, continuous ETCO2 monitoring predicted adequacy of CC and detected ROSC. These findings suggest ETCO2 in conjunction with other devices may be beneficial during CC and predict ROSC.

show abstract

“…1): one in adults 3 and another in newborns. 4 Both of them use qualitative devices in order to assess the quality of ventilation, recovery of spontaneous circulation, increase of heart rate in newborns or find a correlation between the values with survival after CPR. On the one hand, Nakatani et al 3 showed that in adults ventilated with BVM, there was a correlation between superior levels of capnometry detection and ROSC in 15% of patients in the group with CO2 values <0,5% (<4 mmHg) and in 43% of patients who presented values >2% (>15 mmHg).…”

Section: Sirmentioning

confidence: 99%

Capnography as instrument for airway management during basic instrumental CPR manoeuvers

Cereceda-Sánchez

Molina-Mula

2019

Resuscitation

View full text Add to dashboard Cite

There is still controversy today about the superiority of advanced versus basic airway management during CPR maneuvers. This uncertainty was announced in the most recent ILCOR guidelines, and it seems to be corroborated by a recent randomized trial comparing survival and neurological recovery from CPR in patients treated with bag-valve-mask (BVM) versus orotracheal intubation. 1 Although the possibility of using capnography within BVM or extraglottic devices has been indicated by the European Resuscitation Council, 2 it seems not to be common practice at the moment. In order to better understand the current state of the use of capnography with BVM ventilation during CPR, we have conducted a systematic review across various databases using the search: (capnography [MeSH]) AND (Cardiopulmonary resuscitation [MeSH]).Unfortunately, in our research, we only found 2 observational articles correlating capnography values with the results of CPR ( Fig. 1): one in adults 3 and another in newborns. 4 Both of them use qualitative devices in order to assess the quality of ventilation, recovery of spontaneous circulation, increase of heart rate in newborns or find a correlation between the values with survival after CPR. On the one hand, Nakatani et al. 3 showed that in adults ventilated with BVM, there was a correlation between superior levels of capnometry detection and ROSC in 15% of patients in the group with CO2 values <0,5% (<4 mmHg) and in 43% of patients who presented values >2% (>15 mmHg). On the other hand, in the newborn study, the early detection of an increase of capnometry occurred 10-20 s before an increase in heart rate was recorded by the electrocardiogram monitoring.In the literature review, there seems to be a small gap in the use of capnography during instrumental basic resuscitation. We did not find any high-quality randomized clinical trials comparing the capnography values obtained by basic versus advanced life support airway management nor regarding their use to improve the quality of maneuvers. Preliminary findings suggest that with capnography monitoring during BVM ventilation we can achieve and quantify the increased effectiveness of resuscitative efforts.Mask ventilation is difficult and requires good training or experience. In order to quantify the quality of ventilation with BVM, a good methodology could be to assess the ventilation within the capnography monitoring with a scale, as has been proposed by Lim and Nielsen 5 in the context of anesthesia. They establish a 4-level scale of ventilation quality based on the values obtained and the capnogram shape during capnography monitoring. It is interesting to note that in two decades no one else has done a study using quantitative capnography values to compare the difference between BVM ventilation and other advanced airway devices such as extraglottic devices in adults. We have just started a cluster- Fig. 1 -Flow-chart of information, according to the review stages. Resuscitation j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o...

show abstract

Pedi-cap color change precedes a significant increase in heart rate during neonatal resuscitation

Cited by 48 publications

References 25 publications

Tools to assess lung aeration in neonates with respiratory distress syndrome

Tools to assess lung aeration in neonates with respiratory distress syndrome

Continuous capnography monitoring during resuscitation in a transitional large mammalian model of asphyxial cardiac arrest

Capnography as instrument for airway management during basic instrumental CPR manoeuvers

Contact Info

Product

Resources

About