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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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Conclusion: NIRS-based selective shunting during CEA seems to be safe and reliable for monitoring cerebral perfusion in terms of postoperative stroke and neurologic symptoms. It also reduces unnecessary shunt usage. PMID: 29234612 [PubMed]
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: LETTERS Source Type: research
CONCLUSIONS: Prethrombectomy workflows vary widely between experienced centers. Improved awareness of real-world workflows and their variations may help to guide institutions in designing their own protocols of care.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: INTERVENTIONAL Source Type: research
CONCLUSIONS: Preoperative oxygen extraction fraction imaging generated from 7T MR quantitative susceptibility mapping identifies patients at risk for cerebral hyperperfusion following carotid endarterectomy.
Source: American Journal of Neuroradiology - Category: Radiology Authors: Tags: ADULT BRAIN Source Type: research
We examined brain perfusion using single photon emission computed tomography (SPECT) and used three-dimensional stereotactic surface projection (3D-SSP) and the stereotactic extraction estimation method (SEE) level 3 to analyze classified gyrus level segments. We assessed cognitive func tion using the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) grouped into three subgroup domains, language, memory, and praxis. In the follow-up data, some regions were further hypoperfused, reflecting worsening of the disease, while other regions showed alleviated hypoperfusi on, potentially related to the ChEIs ...
Source: Brain Imaging and Behavior - Category: Neurology Source Type: research
Condition:   Perfusion and Hypoxia Interventions:   Diagnostic Test: 18F-FDG PET/CT initial-time imaging;   Diagnostic Test: 18F-FDG PET/CT balanced-time imaging Sponsor:   Harbin Medical University Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conclusion: Decreased chorioretinal perfusion is a multifactorial event and has been implicated in several posterior eye pathologies. Based on our current results, it seems that ischemia of the eye could be due to anatomy (tissue volume) and/or functionality (arterial flow).Case Rep Ophthalmol 2017;8:545 –557
Source: Case Reports in Ophthalmology - Category: Opthalmology Source Type: research
Publication date: Available online 13 December 2017 Source:European Journal of Radiology Author(s): Kohei Sasaguri, Naoki Takahashi As our understanding has expanded that relatively large fraction of incidentally discovered renal masses, especially in small size, are benign or indolent even if malignant, there is growing acceptance of more conservative management including active surveillance for small renal masses. As for advanced renal cell carcinomas (RCCs), nonsurgical and subtype specific treatment options such as immunotherapy and targeted therapy is developing. On these backgrounds, renal mass characterization incl...
Source: European Journal of Radiology - Category: Radiology Source Type: research
ConclusionPAD is an underdiagnosed condition in geriatric patients presenting with ankle fractures. This study underlines the relevance of limb perfusion for adequate wound healing in geriatric ankle fractures. Therefore, special attention should be paid to diagnose and —if indicated—optimise limb perfusion prior to surgical fixation of geriatric ankle fractures.
Source: International Orthopaedics - Category: Orthopaedics Source Type: research
AbstractAdiponectin functions as a promoter of saliva secretion in rat submandibular gland via activation of adenosine monophosphate-activated protein kinase (AMPK) and increased paracellular permeability. Ca2+ mobilization is the primary signal for fluid secretion in salivary acinar cells. However, whether intracellular Ca2+ mobilization is involved in adiponectin-induced salivary secretion is unknown. Here, we found that full-length adiponectin (fAd) increased intracellular Ca2+ and saliva secretion in submandibular glands. Pre-perfusion with ethylene glycol-bis (2-aminoethylether)-N,N,N ′,N′-tetraacetic acid...
Source: Journal of Molecular Histology - Category: Laboratory Medicine Source Type: research
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