Use of end-tidalPco 2 and transcutaneousPco 2 as noninvasive measurement of arterialPco 2 in extubated patients recovering from general anesthesia

Kavanagh, Brian P.; Sandler, Alan N.; Turner, Kim; Wick, V.; Lawson, Stephanie

doi:10.1007/bf01616780

Cited by 21 publications

(14 citation statements)

References 13 publications

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“…When CO2 is measured in expired air, gas sampling is not free from problems, and the correlation to arterial blood concentration is not ideal, owing to various physiological causes (KAVANAGH et al, 1992). Using nasal cannulae to collect the expired air can cause inaccuracy of the measurement.…”

Section: Monitoring Of Blood Gas Concentrationsmentioning

confidence: 98%

“…Among several possible candidate devices for measuring end-tidal 02 (COP, 1988), there seem to be no reports on whether their actual performance is adequate for respiratory monitoring. Transcutaneous CO2 measurements cannot detect respiratory activity breath by breath (KAVANAGH et al, 1992) but provide an estimate of the arterial CO2 concentration. Accuracy is affected by cardiovascular function, peripheral per fusion, local tissue metabolism, age and skin thickness (SANTOS et al, 1994).…”

Section: Monitoring Of Blood Gas Concentrationsmentioning

confidence: 99%

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Critical review of non-invasive respiratory monitoring in medical care

Folke

Cernerud

Ekström

et al. 2003

Med. Biol. Eng. Comput.

389

227

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Respiratory failure can be difficult to predict. It can develop into a life-threatening condition in just a few minutes, or it can build up more slowly. Thus continuous monitoring of respiratory activity should be mandatory in clinical, high-risk situations, and appropriate monitoring equipment could be life-saving. The review considers non-invasive methods and devices claimed to provide information about respiratory rate or depth, or gas exchange. Methods are categorised into those responding to movement, volume and tissue composition detection; air flow; and blood gas concentration. The merits and limitations of the methods and devices are analysed, considering information content and their ability to minimise the rate of false alarms and false non-alarms. It is concluded that the field of non-invasive respiratory monitoring is still in an exploratory phase, with numerous reports on specific device solutions but less work on evaluation and adaptation to clinical requirements. Convincing evidence of the clinical usefulness of respiratory monitors is still lacking. Devices responding only to respiratory rate, and lacking information about actual gas exchange, will have limited clinical value. Furthermore, enhancement in specificity and sensitivity to avoid false alarms and non-alarms will be necessary to meet clinical requirements. Miniature CO2 sensors are identified as one route towards substantial improvement.

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Section: Monitoring Of Blood Gas Concentrationsmentioning

confidence: 98%

Section: Monitoring Of Blood Gas Concentrationsmentioning

confidence: 99%

Critical review of non-invasive respiratory monitoring in medical care

Folke

Cernerud

Ekström

et al. 2003

Med. Biol. Eng. Comput.

389

227

View full text Add to dashboard Cite

show abstract

“…The odor scale assessed odor intensity and irritation on a scale from 0 (barely detectable/no sensation) to 100 (strongest imaginable) and pleasantness (1 = very pleasant to 9 = very unpleasant) (22). The scales were administered at 5-min intervals during the 20- (25,26).…”

Section: Methods Subject Recruitmentmentioning

confidence: 99%

Controlled Human Exposure to Methyl Tertiary Butyl Ether in Gasoline: Symptoms, Psychophysiologic and Neurobehavioral Responses of Self-Reported Sensitive Persons

Fiedler¹,

Kelly‐McNeil²,

Möhr³

et al. 2000

Environmental Health Perspectives

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The 1990 Clean Air Act mandated oxygenation of gasoline in regions where carbon monoxide standards were not met. To achieve this standard, methyl tertiary butyl ether (MTBE) was increased to 15% by volume during winter months in many locations. Subsequent to the increase of MTBE in gasoline, commuters reported increases in symptoms such as headache, nausea, and eye, nose, and throat irritation. The present study compared 12 individuals selected based on selfreport of symptoms (self-reported sensitives; SRSs) associated with MTBE to 19 controls without self-reported sensitivities. In a double-blind, repeated measures, controlled exposure, subjects were exposed for 15 min to dean air, gasoline, gasoline with 11% MTBE, and gasoline with 15% MTBE. Symptoms, odor ratings, neurobehavioral performance on a task of driving simulation, and psychophysiologic responses (heart and respiration rate, end-tidal CO2, finger pulse volume, electromyograph, finger temperature) were measured before, during, and immediately after exposure. Relative to controls, SRSs reported significantly more total symptoms when exposed to gasoline with 15% MTBE than when exposed to gasoline with 11% MTBE or to dean air.However, these differences in symptoms were not accompanied by significant differences in neurobehavioral performance or psychophysiologic responses. No Using a double-blind cross-over design, Prah et al. (8) exposed healthy subjects to 1.4 ppm MTBE versus clean air for 1 hr.Cain et al. (9) exposed healthy subjects for 1 hr to each of three conditions: 1.7 ppm MTBE, 7.1 ppm mixture of 17 volatile organic compounds, and clean air. Neither study found an increase in symptoms, a reduction in neurobehavioral performance, or changes on measures of eye irritation (tear film breakup). The number of polymorphonuclear neutrophil leukocytes in nasal lavage fluid samples was increased only 18-24 hr after exposure to volatile organic compounds (9). In these studies, blood levels of MTBE were higher than the upper quartile levels assessed in the cross-sectional studies of workers. More recently, Nihlen et al. (7) exposed 10 healthy males to 5, 25, and 50 ppm MTBE and found that subjects reported significantly higher ratings of solvent smell with higher exposure to MTBE. Ratings of odor declined over time, suggesting habituation to the odor. No increase in symptoms or changes in objective measures of eye irritation was observed (e.g., tear film breakup time, redness). Nasal airway resistance increased significantly after exposure, but the effect was not correlated with exposure. Thus, in healthy subjects, MTBE exposures under controlled conditions did not replicate the symptoms reported either anecdotally or in cross-sectional community studies. These controlled exposures to MTBE, however, were not those of typical exposures such as refueling or driving, where MTBE is encountered only as an additive to gasoline. Moreover, controlled exposure studies to date have not included self-reported sensitive individuals.As is observed with other noxio...

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“…In addition to the diagnosis of diseases, breath tests have been applied to monitor respiratory processes in medical care (97)(98)(99)(100)(101) and excretion of drugs (12,13,(102)(103)(104)(105).…”

Section: Othersmentioning

confidence: 99%

Breath Analysis: Potential for Clinical Diagnosis and Exposure Assessment

Cao¹,

Duan²

2006

Clinical Chemistry

363

238

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Breath tests are among the least invasive methods available for clinical diagnosis, disease state monitoring, and environmental exposure assessment. In recent years, interest in breath analysis for clinical purposes has increased. This review is intended to describe the potential applications of breath tests, including clinical diagnosis of diseases and monitoring of environmental pollutant exposure, with emphasis on oxidative stress, lung diseases, metabolic disorder, gastroenteric diseases, and some other applications. The application of breath tests in assessment of exposure to volatile organic compounds is also addressed. Finally, both the advantages and limitations of breath analysis are summarized and discussed.

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Use of end-tidalPco 2 and transcutaneousPco 2 as noninvasive measurement of arterialPco 2 in extubated patients recovering from general anesthesia

Cited by 21 publications

References 13 publications

Critical review of non-invasive respiratory monitoring in medical care

Critical review of non-invasive respiratory monitoring in medical care

Controlled Human Exposure to Methyl Tertiary Butyl Ether in Gasoline: Symptoms, Psychophysiologic and Neurobehavioral Responses of Self-Reported Sensitive Persons

Breath Analysis: Potential for Clinical Diagnosis and Exposure Assessment

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