How to Read and Interpret End-Tidal Capnography Waveforms

Capnography is a great way to confirm airway device placement and monitor ventilation, but it can do so much more. Carbon dioxide (CO2) is a product of metabolism transported via perfusion and expelled through ventilation. End-tidal carbon dioxide (EtCO2) waveform monitoring allows you to measure all three simultaneously, making it the most important vital sign you use.1 To evaluate the metabolism, ventilation and perfusion of a patient through EtCO2 waveform monitoring you need to read the PQRST: proper, quantity, rate, shape and trend. Proper means that you should know the normal readings for quantity, rate, shape and trending of EtCO2. In this case, normal means what we find in a healthy person with no metabolism, ventilation or perfusion problems. One of the great things about EtCO2 is that although ventilation rates vary based on age, normal readings for quantity, shape and trends are the same for men and women of all age groups, making them easy to remember. Quantity; target EtCO2 value should be 35-45 mmHg. Rate of ventilation should be 12-20 breaths per minute (bpm) for adults if the patient is breathing on their own and 10-12 bpm if you're ventilating them. Children should be ventilated at a rate of 15-30 bpm; 25-50 bpm for infants. Ventilating too quickly won't let enough CO2 build up in the alveoli, resulting in lower EtCO2 readings. Ventilating too slowly will allow extra CO2 to build up, resulting in higher readings. Shape of the waveform should normally be a rec...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Patient Care Source Type: news

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Lab Chip, 2018, Accepted Manuscript DOI: 10.1039/C8LC00394G, PaperYing I. Wang, Michael Louis Shuler Microphysiological systems, also known as body-on-a-chips, are promising “human surrogates” that may be used to evaluate potential human response to drugs in preclinical drug development. Various microfluidics-based platforms have been... The content of this RSS Feed (c) The Royal Society of Chemistry
Source: RSC - Lab Chip latest articles - Category: Chemistry Authors: Source Type: research
ConclusionCurrent study proposes an automatic method for segmentation between non-enhancing tumor and vasogenic edema in HGG patients, based on an SVM classifier which used an alternative ground truth to that of radiologist’s manual delineation of tumor. The proposed methodology can prove to be a useful tool for pre and post-operative evaluation of glioma patients.
Source: European Journal of Radiology - Category: Radiology Source Type: research
ConclusionsHigh-quality chest compressions coupled with aortic occlusion may generate adequate perfusion pressures to increase the rate of ROSC. New technology capable of transducing central arterial pressure may help us to understand the effectiveness of CPR with and without aortic occlusion. REBOA may be a useful adjunct to high-quality chest compressions during arrest.
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
AbstractPurpose of ReviewThe purpose was to review the most recent literature on neuroimaging in the Kleine-Levin syndrome (KLS). We aimed to investigate if frontotemporal and thalamic dysfunction are key KLS signatures, and if recent research indicates other brain networks of interest that elucidate KLS symptomatology and aetiology.Recent FindingsIn a comprehensive literature search, we found 12 original articles published 2013 –2018. Most studies report deviations related to cerebral perfusion, glucose metabolism, or blood-oxygen-level-dependent responses in frontotemporal areas and/or the thalamus. Studies also re...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
Publication date: September 2018Source: European Journal of Radiology, Volume 106Author(s): Davide Ippolito, Giulia Querques, Stefano Okolicsanyi, Cammillo Talei Franzesi, Anna Pecorelli, Sophie Lombardi, Eleonora Orsini, Mario Strazzabosco, Sandro SironiAbstractPurposeTo investigate whether perfusion-CT (p-CT) imaging could depict the inhibition of tumor neoangiogenesis induced by Sorafenib in advanced hepatocellular carcinoma (HCC), and whether it could be useful in predicting survival during treatment.Materials and methodsNinety-eight p-CT examinations were performed among 29 cirrhotic patients, with advanced HCC, befor...
Source: European Journal of Radiology - Category: Radiology Source Type: research
Abdominal aortic aneurysm (AAA) is an individual and socioeconomic burden in today's ageing society. Treatment relies on surgical exclusion of the dilated aorta by open or endovascular repair. For research purposes, animal models are necessary and the elastase induced aneurysm model closely mimics end stage human aneurysm disease. To improve the translational value of this model, four modifications to the classic elastase perfusion procedure (PPE) in relation to human aneurysm morphology were conducted.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Selected Abstract from the July Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research
Endovascular treatment of type B aortic dissection provides effective relief of distal malperfusion by increasing true luminal size and perfusion distally.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Abstract from the 2018 Eastern Vascular Society Annual Meeting Source Type: research
Objective: The present study aimed the functional recovery evaluation after long term of cardiac arrest induced by Custodiol (crystalloid-based) versus del Nido (blood-based) solutions, both added lidocaine and pinacidil as cardioplegic agents. Experiments were performed in isolated rat heart perfusion models.Methods: Male rat heart perfusions, according to Langendorff technique, were induced to cause 3 hours of cardiac arrest with a single dose. The hearts were assigned to one of the following three groups: (I) control; (II) Custodiol-LP; and (III) del Nido-LP. They were e...
Source: Brazilian Journal of Cardiovascular Surgery - Category: Cardiology Source Type: research
Objective: To compare the effects of extended- versus short-time noninvasive positive pressure ventilation on pulmonary function, tissue perfusion, and clinical outcomes in the early postoperative period following coronary artery bypass surgery in patients with preserved left ventricular function.Methods: Patients were randomized into two groups according to noninvasive positive pressure ventilation intensity: short-time noninvasive positive pressure ventilation n=20 (S-NPPV) and extended-time noninvasive positive pressure ventilation n=21 (E-NPPV). S-NPPV was applied for 60...
Source: Brazilian Journal of Cardiovascular Surgery - Category: Cardiology Source Type: research
Publication date: Available online 19 July 2018Source: NeuronAuthor(s): Qingjian Han, Di Liu, Marino Convertino, Zilong Wang, Changyu Jiang, Yong Ho Kim, Xin Luo, Xin Zhang, Andrea Nackley, Nikolay V. Dokholyan, Ru-Rong JiSummaryIncreasing evidence suggests that extracellular miRNAs may serve as biomarkers of diseases, but the physiological relevance of extracellular miRNA is unclear. We find that intradermal cheek injection of miR-711 induces TRPA1-depedent itch (scratching) without pain (wiping) in naive mice. Extracellular perfusion of miR-711 induces TRPA1 currents in both Trpa1-expressing heterologous cells and native...
Source: Neuron - Category: Neuroscience Source Type: research
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