Predictive Value of Capnography for Suspected Diabetic Ketoacidosis in the Emergency Department

Soleimanpour, Hassan; Taghizadieh, Ali; Niafar, Mitra; Rahmani, Farzad; Golzari, Samad Ej; Esfanjani, Robab Mehdizadeh

doi:10.5811/westjem.2013.4.14296

Cited by 27 publications

(39 citation statements)

References 13 publications

(16 reference statements)

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“…Palma de Mallorca, IB, Spain, 2016AuthornCannula usedType of sensor Capnograph usedMeasurement durationPishbin et al ( 1 ) 64Nc*SidestreamCapnocheck (r) Sleep Capnograp/oximeter.NK/NA † Agus et al ( 11 ) 72Nc*MicrostreamMDE Escort Prism (r) monitorNK/NA † Gilhotra & Porter ( 23 ) 58Nc*SidestreamPhilips M3046A.1 minSolana et al ( 12 ) 25Nco ‡ MicrostreamPhilips smarth capnoline O2 pediatrics.30 sec-1minNagler et al ( 24 ) 130Nco ‡ MicrostreamMicrocap; Oridion.1-2 minKartal et al ( 29 ) 240O § SidestreamMedlab Cap 10 sidestream.NK/NA † McGillicuddy et al ( 30 ) 97NK/NA † MicrostreamNelcor NBP-70.NK/NA † Soleimanpour et al ( …”

Section: Resultsmentioning

confidence: 99%

“…Among those studies focused directly on metabolic changes, it was found a study 3 that is the only one aiming at the detection of DKA in adults. In such a study, it was obtained a moderate correlation between EtCO 2 and PaCO 2 (0.572, p>0.0001) and a strong correlation between EtCO 2 and HCO 3 ¯ (r=0.730, p>0.0001), indicating that values of EtCO 2 > 24.5mmHg were out of the interval for DKA, with sensitivity of 0.90 and specificity of 0.90.…”

Section: Resultsmentioning

confidence: 99%

“…Through it, a supplementary monitoring to pulse oximetry is achieved, as capnography provides direct and immediate information on ventilation, whereas pulse oximetry only quantifies oxygenation 7 . With the use of capnography, it is possible to know objectively the patients' metabolic status 1 - 3 , correct installation of orotracheal tube (OTT) in the bronchial tree, quality and effectiveness of cardiopulmonary resuscitation (CPR) maneuvers, restoration of spontaneous circulation during CPR, monitoring of invasive and non-invasive mechanical ventilation and spontaneous ventilation 8 - 10 .…”

Section: Introductionmentioning

confidence: 99%

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Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting

Cereceda-Sánchez

Molina-Mula

2017

Rev. Latino-Am. Enfermagem

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Objective:to evaluate the usefulness of capnography for the detection of metabolic changes in spontaneous breathing patients, in the emergency and intensive care settings. Methods:in-depth and structured bibliographical search in the databases EBSCOhost, Virtual Health Library, PubMed, Cochrane Library, among others, identifying studies that assessed the relationship between capnography values and the variables involved in blood acid-base balance. Results:19 studies were found, two were reviews and 17 were observational studies. In nine studies, capnography values were correlated with carbon dioxide (CO2), eight with bicarbonate (HCO3), three with lactate, and four with blood pH. Conclusions:most studies have found a good correlation between capnography values and blood biomarkers, suggesting the usefulness of this parameter to detect patients at risk of severe metabolic change, in a fast, economical and accurate way.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting

Cereceda-Sánchez

Molina-Mula

2017

Rev. Latino-Am. Enfermagem

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“…To evaluate lung sliding, linear probe was placed on anterior chest in midclavicular line in both hemithorax, and lung movement across parietal pleura was seen as slipping. The results of intubation were confirmed or rejected by capnography (18). The results were analysed by SPSS Version 17.01 (SPSS Inc., Chicago, Illinois).…”

Section: Methodsmentioning

confidence: 95%

Diagnostic Value of Sonography for Confirmation of Endotracheal Intubation in the Emergency Department

et al. 2017

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BackgroundIntubation and maintaining airway are crucial in the management of critically ill patients in the emergency department. Correct tracheal intubation should be confirmed by the physician, otherwise oesophageal intubation could lead to hypoxia with detrimental consequences and even death. Sonography can be used to determine proper placement of the tracheal tube.MethodsIn this study, 75 patients, with an indication of intubation and age older than 18 years entered the study. An emergency medicine performed real-time sonography of the trachea to evaluate the correct placement of endotracheal tube. Tube passage (snowstorm) and vocal cord angel widening (bullet sign) were evaluated, and then both lungs sliding and diaphragm movement were evaluated to confirm correct tube placement and ventilation.ResultsIn this study, 75 patients entered the study. The mean age of the patients was 61.12; 47 patients (62.7%) were male and 28 (37.3%) were female. The reason of intubation was the decreased level of consciousness in 22 cases (29.3%), cardiopulmonary arrest in 22 patients (29.3%), respiratory distress in 9 patients (12%), shock in 10 patients (13.3%), and seizure in 1 case. Snowstorm sign was seen in 72 patients (96%). Bullet sign was objected in 24 cases (32%). Lung sliding was seen bilaterally in 63 patients (84%) and unilaterally in 7 patients (9.3 %), but it was not noticed in 6.7% of the patients (5 patients).ConclusionsTransverse tracheal and lung sonography in the emergency department can be a fast measure to confirm correct endotracheal intubation.

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“…Currently, capnography is used to evaluate ventilation in clinical wards. Capnography produces the a value for end tidal carbon dioxide (ETCO 2 ) and can precisely monitor a patient’s ventilation status (9, 10). Given the above, it appears that use of a ventilation monitor in multiple trauma patients, especially with a neck collar, is necessary.…”

Section: Introductionmentioning

confidence: 99%

Effect of Neck Collar Fixation on Ventilation in Multiple Trauma Patients

Rahmani¹,

Pouraghaei²,

Moharamzadeh³

et al. 2016

Trauma Mon

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BackgroundAccording to the guidelines for treatment of multiple trauma patients, immobilization of the neck and neck collar fixation are essential. However, following neck collar fixation patients usually experience dyspnea. Some studies have found that neck collar fixation can lead to decreased pulmonary volumes, yet there have been no studies on the effect of neck collar fixation on patient ventilation.ObjectivesThe purpose of this study was to determine the effect of neck collar fixation on ventilation in multiple trauma patients.MethodsThis study was a descriptive-analytical study, which was performed in the emergency department of Tabriz University of Medical Sciences on multiple trauma patients with a Glasgow Coma Score (GCS) of 15. The effect of neck collar fixation on ventilation in the study participants was examined with the use of capnography.ResultsThis study involved 163 multiple trauma patients. Of these, 65% were male. The mean of end tidal carbon dioxide (ETCO2) of the patients without neck collars was 34.62 ± 4.46 and the mean ETCO2 of the patients with neck collars was 34.21 ± 2.31. There was no significant difference between the means of ETCO2, before and after removing the neck collar, among the studied patients (P = 0.196).ConclusionsAccording to the results of our study, neck collar fixation has no effect on ventilation in multiple trauma patients.

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Predictive Value of Capnography for Suspected Diabetic Ketoacidosis in the Emergency Department

Cited by 27 publications

References 13 publications

Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting

Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting

Diagnostic Value of Sonography for Confirmation of Endotracheal Intubation in the Emergency Department

Effect of Neck Collar Fixation on Ventilation in Multiple Trauma Patients

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