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Current methodological and technical limitations of time and volumetric capnography in newborns

Although capnography is a standard tool in mechanically ventilated adult and pediatric patients, it has physiological and technical limitations in neonates. Gas exchange differs between small and adult lungs due to the greater impact of small airways on gas exchange, the higher impact of the apparat...

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Autor principal: Schmalisch, Gerd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004292/
https://www.ncbi.nlm.nih.gov/pubmed/27576441
http://dx.doi.org/10.1186/s12938-016-0228-4
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author Schmalisch, Gerd
author_facet Schmalisch, Gerd
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description Although capnography is a standard tool in mechanically ventilated adult and pediatric patients, it has physiological and technical limitations in neonates. Gas exchange differs between small and adult lungs due to the greater impact of small airways on gas exchange, the higher impact of the apparatus dead space on measurements due to lower tidal volume and the occurrence of air leaks in intubated patients. The high respiratory rate and low tidal volume in newborns, especially those with stiff lungs, require main-stream sensors with fast response times and minimal dead-space or low suction flow when using side-stream measurements. If these technical requirements are not fulfilled, the measured end-tidal CO(2) (P(et)CO(2)), which should reflect the alveolar CO(2) and the calculated airway dead spaces, can be misleading. The aim of this survey is to highlight the current limitations of capnography in very young patients to avoid pitfalls associated with the interpretation of capnographic parameters, and to describe further developments.
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spelling pubmed-50042922016-08-31 Current methodological and technical limitations of time and volumetric capnography in newborns Schmalisch, Gerd Biomed Eng Online Review Although capnography is a standard tool in mechanically ventilated adult and pediatric patients, it has physiological and technical limitations in neonates. Gas exchange differs between small and adult lungs due to the greater impact of small airways on gas exchange, the higher impact of the apparatus dead space on measurements due to lower tidal volume and the occurrence of air leaks in intubated patients. The high respiratory rate and low tidal volume in newborns, especially those with stiff lungs, require main-stream sensors with fast response times and minimal dead-space or low suction flow when using side-stream measurements. If these technical requirements are not fulfilled, the measured end-tidal CO(2) (P(et)CO(2)), which should reflect the alveolar CO(2) and the calculated airway dead spaces, can be misleading. The aim of this survey is to highlight the current limitations of capnography in very young patients to avoid pitfalls associated with the interpretation of capnographic parameters, and to describe further developments. BioMed Central 2016-08-30 /pmc/articles/PMC5004292/ /pubmed/27576441 http://dx.doi.org/10.1186/s12938-016-0228-4 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Schmalisch, Gerd
Current methodological and technical limitations of time and volumetric capnography in newborns
title Current methodological and technical limitations of time and volumetric capnography in newborns
title_full Current methodological and technical limitations of time and volumetric capnography in newborns
title_fullStr Current methodological and technical limitations of time and volumetric capnography in newborns
title_full_unstemmed Current methodological and technical limitations of time and volumetric capnography in newborns
title_short Current methodological and technical limitations of time and volumetric capnography in newborns
title_sort current methodological and technical limitations of time and volumetric capnography in newborns
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004292/
https://www.ncbi.nlm.nih.gov/pubmed/27576441
http://dx.doi.org/10.1186/s12938-016-0228-4
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