Skip to main content
Top

2024 | OriginalPaper | Hoofdstuk

11. Capnografie

Auteur : Hans ter Haar

Gepubliceerd in: Mechanische beademing op de intensive care

Uitgeverij: Bohn Stafleu van Loghum

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Kooldioxide dat vrijkomt bij de verbranding wordt via het bloed naar de longen vervoerd om daar te worden uitgeademd. De kooldioxideconcentratie kan gemeten en grafisch weergegeven worden. De weergave van de kooldioxideconcentratie als getalswaarde wordt capnometrie genoemd, de grafische weergave van de kooldioxideconcentratie wordt capnografie genoemd. Grafisch gezien onderscheiden we tijdgebaseerde capnografie, waarbij de kooldioxideconcentratie wordt uitgezet tegen de tijd, en volumegebaseerde (volumetrische) capnografie, waarbij de kooldioxideconcentratie wordt uitgezet tegen het uitgeademde volume. Instrumenttechnisch gezien onderscheiden we mainstream en sidestream capnografie: bij mainstream capnografie zit de opnemer dichtbij de tube, bij sidestream capnografie zit de opnemer in de beademingsmachine of in de monitor. Capnografie is in navolging van het gebruik op de operatiekamers volledig ingeburgerd op elke afdeling waar patiënten mechanisch beademd worden. Ze vervult een belangrijke rol bij de bewaking van de luchtweg en het sturen van de therapie en geeft informatie over aandoening en prognose.
Literatuur
1.
go back to reference Walsh BK, Crotwell DN, Restrepo RD. Capnography/capnometry during mechanical ventilation: 2011. Respir Care. 2011;56(4):503–9.PubMedCrossRef Walsh BK, Crotwell DN, Restrepo RD. Capnography/capnometry during mechanical ventilation: 2011. Respir Care. 2011;56(4):503–9.PubMedCrossRef
2.
go back to reference Hardman JG, Curran J, Mahajan RP. End-tidal carbon dioxide measurement and breathing system filters. Anaesthesia. 1997;52(7):646–8.PubMedCrossRef Hardman JG, Curran J, Mahajan RP. End-tidal carbon dioxide measurement and breathing system filters. Anaesthesia. 1997;52(7):646–8.PubMedCrossRef
3.
go back to reference Fletcher R, Werner O, Nordstrom L, Jonson B. Sources of error and their correction in the measurement of carbon dioxide elimination using the Siemens-Elema CO2 analyzer. Br J Anaesth. 1983;55(2):177–85.PubMedCrossRef Fletcher R, Werner O, Nordstrom L, Jonson B. Sources of error and their correction in the measurement of carbon dioxide elimination using the Siemens-Elema CO2 analyzer. Br J Anaesth. 1983;55(2):177–85.PubMedCrossRef
4.
go back to reference Kodali BS, Philip JH. Defining segments and phases of a time capnogram. Anesth Analg. 2000;91:973–7.CrossRef Kodali BS, Philip JH. Defining segments and phases of a time capnogram. Anesth Analg. 2000;91:973–7.CrossRef
5.
6.
go back to reference Tusman G, Suarez-Sipmann F, Böhm SH, et al. Monitoring dead space during recruitment and PEEP titration in an experimental model. Intensive Care Med. 2006;32:1863–71.PubMedCrossRef Tusman G, Suarez-Sipmann F, Böhm SH, et al. Monitoring dead space during recruitment and PEEP titration in an experimental model. Intensive Care Med. 2006;32:1863–71.PubMedCrossRef
7.
go back to reference Kodali BS, Kumar AY, Moseley HSL, Hallsworth RA. Terminology and the current limitations of time capnography: a brief review. J Clin Monit. 1995;11:175–82.CrossRef Kodali BS, Kumar AY, Moseley HSL, Hallsworth RA. Terminology and the current limitations of time capnography: a brief review. J Clin Monit. 1995;11:175–82.CrossRef
8.
go back to reference Fletcher R, Jonson B, Cumming G, Brew J. The concept of dead space with special reference to the single breath test for CO2. Br J Anaesth. 1981;53:77–88.PubMedCrossRef Fletcher R, Jonson B, Cumming G, Brew J. The concept of dead space with special reference to the single breath test for CO2. Br J Anaesth. 1981;53:77–88.PubMedCrossRef
9.
go back to reference Arnold JH, Thompson JE, Arnold LW. Single breath CO2 analysis: description and validation of a method. Crit Care Med. 1996;24(1):96–102.PubMedCrossRef Arnold JH, Thompson JE, Arnold LW. Single breath CO2 analysis: description and validation of a method. Crit Care Med. 1996;24(1):96–102.PubMedCrossRef
10.
go back to reference Sinha P, Flower O, Soni N. Dead space ventilation: a waste of breath. Intensive Care Med. 2011;37:735–46.PubMedCrossRef Sinha P, Flower O, Soni N. Dead space ventilation: a waste of breath. Intensive Care Med. 2011;37:735–46.PubMedCrossRef
11.
go back to reference Tusman G, Suarez-Sipmann F, Böhm SH, et al. Capnography reflects ventilation/perfusion distribution in a model of acute lung injury. Acta Anaesthesiol Scand. 2011;55(5):597–606.PubMedCrossRef Tusman G, Suarez-Sipmann F, Böhm SH, et al. Capnography reflects ventilation/perfusion distribution in a model of acute lung injury. Acta Anaesthesiol Scand. 2011;55(5):597–606.PubMedCrossRef
12.
go back to reference Tusman G, Suarez-Sipmann F, Borges JB, et al. Validation of Bohr dead space measured by volumetric capnography. Intensive Care Med. 2011;37:870–4.PubMedCrossRef Tusman G, Suarez-Sipmann F, Borges JB, et al. Validation of Bohr dead space measured by volumetric capnography. Intensive Care Med. 2011;37:870–4.PubMedCrossRef
13.
go back to reference Enghoff H. Volumen inefficax: bemerkungen zur frage des schadlichen raumes. Upsala Läkarefören Förh. 1938;44:191–218. Enghoff H. Volumen inefficax: bemerkungen zur frage des schadlichen raumes. Upsala Läkarefören Förh. 1938;44:191–218.
14.
go back to reference Suarez-Sipmann F, Bohm SH, Tusman G. Volumetric capnography: the time has come. Curr Opin Crit Care. 2014;20:333–9.PubMedCrossRef Suarez-Sipmann F, Bohm SH, Tusman G. Volumetric capnography: the time has come. Curr Opin Crit Care. 2014;20:333–9.PubMedCrossRef
15.
go back to reference Verscheure S, Massion PB, Verschuren F, et al. Volumetric capnography: lessons from the past and current clinical applications. Crit Care. 2016;20:184.PubMedPubMedCentralCrossRef Verscheure S, Massion PB, Verschuren F, et al. Volumetric capnography: lessons from the past and current clinical applications. Crit Care. 2016;20:184.PubMedPubMedCentralCrossRef
16.
go back to reference Thim T, Vinther NH, Krarup, et al. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Int J Gen Med. 2012;5:117–21. Thim T, Vinther NH, Krarup, et al. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Int J Gen Med. 2012;5:117–21.
17.
go back to reference Neumar RW, Otto CW, Link MS, et al. American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S729–67.PubMed Neumar RW, Otto CW, Link MS, et al. American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S729–67.PubMed
18.
go back to reference Rudraraju P, Eisen LA. Confirmation of endotracheal tube position: a narrative review. J Intensive Care Med. 2009;24(5):283–92.PubMedCrossRef Rudraraju P, Eisen LA. Confirmation of endotracheal tube position: a narrative review. J Intensive Care Med. 2009;24(5):283–92.PubMedCrossRef
19.
go back to reference Poirier MP. Gonzalez Del-Rey JA, McAneney CM, DiGiulio GA. Utility of monitoring capnography, pulse oximetry, and vital signs in the detection of airway mishaps: a hyperoxemic animal model. Am J Emerg Med. 1998;16(4):350–2. Poirier MP. Gonzalez Del-Rey JA, McAneney CM, DiGiulio GA. Utility of monitoring capnography, pulse oximetry, and vital signs in the detection of airway mishaps: a hyperoxemic animal model. Am J Emerg Med. 1998;16(4):350–2.
20.
go back to reference Shibutani K, Muraoka M, Shirasaki S, et al. Do changes in end-tidal Pco2 quantitatively reflect changes in cardiac output? Anesth Analg. 1994;79(5):829–33.PubMedCrossRef Shibutani K, Muraoka M, Shirasaki S, et al. Do changes in end-tidal Pco2 quantitatively reflect changes in cardiac output? Anesth Analg. 1994;79(5):829–33.PubMedCrossRef
21.
go back to reference Kreit JW. Volume capnography in the intensive care unit: physiological principles, measurements, and calculations. Ann Am Thorac Soc. 2019;16(3):291–300.PubMed Kreit JW. Volume capnography in the intensive care unit: physiological principles, measurements, and calculations. Ann Am Thorac Soc. 2019;16(3):291–300.PubMed
22.
go back to reference Kline JA, Israel EG, Michelson EA, et al. Diagnostic accuracy of a bedside D-dimer assay and alveolar dead-space measurement for rapid exclusion of pulmonary embolism: a multicenter study. JAMA. 2001;285(6):761–8.PubMedCrossRef Kline JA, Israel EG, Michelson EA, et al. Diagnostic accuracy of a bedside D-dimer assay and alveolar dead-space measurement for rapid exclusion of pulmonary embolism: a multicenter study. JAMA. 2001;285(6):761–8.PubMedCrossRef
23.
go back to reference Falk JL, Rackow EC, Weil MH. End-tidal carbon dioxide concentration during cardiopulmonary resuscitation. N Engl J Med. 1988;318:607–11.PubMedCrossRef Falk JL, Rackow EC, Weil MH. End-tidal carbon dioxide concentration during cardiopulmonary resuscitation. N Engl J Med. 1988;318:607–11.PubMedCrossRef
24.
go back to reference Gudipati CV, Weil MH, Bisera J, et al. Expired carbon dioxide: a noninvasive monitor of cardiopulmonary resuscitation. Circulation. 1988;77(1):234–9.PubMedCrossRef Gudipati CV, Weil MH, Bisera J, et al. Expired carbon dioxide: a noninvasive monitor of cardiopulmonary resuscitation. Circulation. 1988;77(1):234–9.PubMedCrossRef
25.
go back to reference Sanders AB, Kern KB, Otto CW. End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. A prognostic indicator for survival JAMA. 1989;262:1347–51.PubMed Sanders AB, Kern KB, Otto CW. End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. A prognostic indicator for survival JAMA. 1989;262:1347–51.PubMed
26.
go back to reference Dubin A, Murias G, Estenssoro E, et al. End-tidal CO2 pressure determinants during hemorrhagic shock. Intensive Care Med. 2000;26:1619–23.PubMedCrossRef Dubin A, Murias G, Estenssoro E, et al. End-tidal CO2 pressure determinants during hemorrhagic shock. Intensive Care Med. 2000;26:1619–23.PubMedCrossRef
27.
go back to reference Isserles SA, Breen PH. Can changes in end-tidal Pco2 measure changes in cardiac output? Anesth Analg. 1991;73:808–14.PubMedCrossRef Isserles SA, Breen PH. Can changes in end-tidal Pco2 measure changes in cardiac output? Anesth Analg. 1991;73:808–14.PubMedCrossRef
28.
go back to reference Romero PV, Rodriguez B, De Oliveira D, et al. Volumetric capnography and COPD staging. Int J Chron Obstruct Pulmon Dis. 2007;2(3):381–91.PubMedPubMedCentral Romero PV, Rodriguez B, De Oliveira D, et al. Volumetric capnography and COPD staging. Int J Chron Obstruct Pulmon Dis. 2007;2(3):381–91.PubMedPubMedCentral
29.
go back to reference Kars AH, Bogaard JM, Stijnen T, et al. Dead space and slope indices from the expiratory carbon dioxide tension-volume curve. Eur Respir J. 1997;10:1829–36.PubMedCrossRef Kars AH, Bogaard JM, Stijnen T, et al. Dead space and slope indices from the expiratory carbon dioxide tension-volume curve. Eur Respir J. 1997;10:1829–36.PubMedCrossRef
30.
go back to reference Suter PM, Fairley B, Isenberg MD. Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med. 1975;292:284–9.PubMedCrossRef Suter PM, Fairley B, Isenberg MD. Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med. 1975;292:284–9.PubMedCrossRef
31.
go back to reference Yang Y, Huang Y, Tang R, et al. Optimization of positive end-expiratory pressure by volumetric capnography variables in lavage-induced acute lung injury. Respiration. 2014;87:75–83.PubMedCrossRef Yang Y, Huang Y, Tang R, et al. Optimization of positive end-expiratory pressure by volumetric capnography variables in lavage-induced acute lung injury. Respiration. 2014;87:75–83.PubMedCrossRef
32.
go back to reference Böhm SH, Maisch S, Von Sandersleben A, et al. The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients. Anesth Analg. 2009;109:151–9.PubMedCrossRef Böhm SH, Maisch S, Von Sandersleben A, et al. The effects of lung recruitment on the phase III slope of volumetric capnography in morbidly obese patients. Anesth Analg. 2009;109:151–9.PubMedCrossRef
33.
go back to reference Tusman G, Böhm SH, Suarez-Sipmann F, Turchetto E. Dead space analysis before and after lung recruitment. Can J Anesth. 2004;51:723–7.PubMedCrossRef Tusman G, Böhm SH, Suarez-Sipmann F, Turchetto E. Dead space analysis before and after lung recruitment. Can J Anesth. 2004;51:723–7.PubMedCrossRef
34.
go back to reference Maisch S, Reissmann H, Fuellekrug B, et al. Compliance and dead space fraction indicate an optimal level of positive end-expiratory pressure after recruitment in anesthetized patients. Anesth Analg. 2008;106:175–81.PubMedCrossRef Maisch S, Reissmann H, Fuellekrug B, et al. Compliance and dead space fraction indicate an optimal level of positive end-expiratory pressure after recruitment in anesthetized patients. Anesth Analg. 2008;106:175–81.PubMedCrossRef
35.
go back to reference Valta P, Uusaro A, Nunes S, et al. Acute respiratory distress syndrome: frequency, clinical course, and costs of care. Crit Care Med. 1999;27:2367–74.PubMedCrossRef Valta P, Uusaro A, Nunes S, et al. Acute respiratory distress syndrome: frequency, clinical course, and costs of care. Crit Care Med. 1999;27:2367–74.PubMedCrossRef
36.
go back to reference Kallet RH, Alonso JA, Pittet JF, Matthay MA. Prognostic value of the pulmonary dead-space fraction during the first 6 days of acute respiratory distress syndrome. Respir Care. 2004;49:1008–14.PubMed Kallet RH, Alonso JA, Pittet JF, Matthay MA. Prognostic value of the pulmonary dead-space fraction during the first 6 days of acute respiratory distress syndrome. Respir Care. 2004;49:1008–14.PubMed
37.
38.
go back to reference Charron C, Repesse X, Bouferrache K, et al. Paco2 and alveolar dead space are more relevant than Pao2/Fio2 ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study. Crit Care. 2011;15:R175.PubMedPubMedCentralCrossRef Charron C, Repesse X, Bouferrache K, et al. Paco2 and alveolar dead space are more relevant than Pao2/Fio2 ratio in monitoring the respiratory response to prone position in ARDS patients: a physiological study. Crit Care. 2011;15:R175.PubMedPubMedCentralCrossRef
39.
go back to reference Gattinoni L, Vagginelli F, Carlesso E, et al. Decrease in Paco2 with prone position is predictive of improved outcome in acute respiratory distress syndrome. Crit Care Med. 2003;31(12):2727–33.PubMedCrossRef Gattinoni L, Vagginelli F, Carlesso E, et al. Decrease in Paco2 with prone position is predictive of improved outcome in acute respiratory distress syndrome. Crit Care Med. 2003;31(12):2727–33.PubMedCrossRef
40.
go back to reference Monge García IN, Cano AG, Romero MG, et al. Non-invasive assessment of fluid responsiveness by changes in partial end-tidal CO2 pressure during a passive leg-raising maneuver. Ann of Intensive Care. 2012;2:9.CrossRef Monge García IN, Cano AG, Romero MG, et al. Non-invasive assessment of fluid responsiveness by changes in partial end-tidal CO2 pressure during a passive leg-raising maneuver. Ann of Intensive Care. 2012;2:9.CrossRef
41.
go back to reference Verschuren F, Heinonen E, Clause D, et al. Volumetric capnography as a bedside monitoring of thrombolysis in major pulmonary embolism. Intensive Care Med. 2004;30(11):2129–32.PubMedCrossRef Verschuren F, Heinonen E, Clause D, et al. Volumetric capnography as a bedside monitoring of thrombolysis in major pulmonary embolism. Intensive Care Med. 2004;30(11):2129–32.PubMedCrossRef
42.
go back to reference Walker RN, Heuberger RA. Predictive equations for energy needs for the critically ill. Respir Care. 2009;54(4):509–21.PubMed Walker RN, Heuberger RA. Predictive equations for energy needs for the critically ill. Respir Care. 2009;54(4):509–21.PubMed
43.
go back to reference Weir JB, de V. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109:1–9. Weir JB, de V. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol. 1949;109:1–9.
44.
go back to reference Fung EB. Estimating energy expenditure in critically ill adults and children. AACN Clin Issues. 2000;11:480–97.PubMedCrossRef Fung EB. Estimating energy expenditure in critically ill adults and children. AACN Clin Issues. 2000;11:480–97.PubMedCrossRef
45.
go back to reference Siobal MS, Hammoudeh H, Snow M. Accuracy of resting energy expenditure calculated by a modification of the abbreviated Weir equation in mechanically ventilated adult ICU patients (Abstract). Respir Care. 2012;57(10):1721. Siobal MS, Hammoudeh H, Snow M. Accuracy of resting energy expenditure calculated by a modification of the abbreviated Weir equation in mechanically ventilated adult ICU patients (Abstract). Respir Care. 2012;57(10):1721.
46.
go back to reference Shimada Y, Yoshiya I, Tanaka K, et al. Evaluation of the progress and prognosis of adult respiratory distress syndrome. Simple respiratory physiologic measurement Chest. 1979;76:180–6.PubMed Shimada Y, Yoshiya I, Tanaka K, et al. Evaluation of the progress and prognosis of adult respiratory distress syndrome. Simple respiratory physiologic measurement Chest. 1979;76:180–6.PubMed
47.
go back to reference Nuckton TJ, Alonso JA, Kallet RH, et al. Pulmonary deadspace fraction as a risk factor for death in the acute respiratory distress syndrome. N Engl J Med. 2002;346:1281–6.PubMedCrossRef Nuckton TJ, Alonso JA, Kallet RH, et al. Pulmonary deadspace fraction as a risk factor for death in the acute respiratory distress syndrome. N Engl J Med. 2002;346:1281–6.PubMedCrossRef
48.
go back to reference Cepkova M, Kapur V, Ren X, et al. Pulmonary dead space fraction and pulmonary artery systolic pressure as early predictors of clinical outcome in acute lung injury. Chest. 2007;132:836–42.PubMedCrossRef Cepkova M, Kapur V, Ren X, et al. Pulmonary dead space fraction and pulmonary artery systolic pressure as early predictors of clinical outcome in acute lung injury. Chest. 2007;132:836–42.PubMedCrossRef
49.
go back to reference Raurich JM, Vilar M, Colomar A, et al. Prognostic value of the pulmonary dead-space fraction during the early and intermediate phases of acute respiratory distress syndrome. Respir Care. 2010;55:282–7.PubMed Raurich JM, Vilar M, Colomar A, et al. Prognostic value of the pulmonary dead-space fraction during the early and intermediate phases of acute respiratory distress syndrome. Respir Care. 2010;55:282–7.PubMed
50.
go back to reference Kallet RH, Zhuo H, Ho K, et al. Lung injury etiology and other factors influencing the relationship between dead-space fraction and mortality in ARDS. Respir Care. 2017;62(10):1241–8.PubMedCrossRef Kallet RH, Zhuo H, Ho K, et al. Lung injury etiology and other factors influencing the relationship between dead-space fraction and mortality in ARDS. Respir Care. 2017;62(10):1241–8.PubMedCrossRef
Metagegevens
Titel
Capnografie
Auteur
Hans ter Haar
Copyright
2024
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-3031-7_11