• Fernando Suarez Sipmann, Juan Antonio Sanchez Giralt, and Gerardo Tusman.
• Department of Intensive Care Medicine, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid.
• Curr Opin Crit Care. 2024 Jun 1; 30 (3): 251259251-259.

Purpose Of ReviewTo describe current and near future developments and applications of CO2 kinetics in clinical respiratory and cardiovascular monitoring.Recent FindingsIn the last years, we have witnessed a renewed interest in CO2 kinetics in relation with a better understanding of volumetric capnography and its derived parameters. This together with technological advances and improved measurement systems have expanded the monitoring potential of CO2 kinetics including breath by breath continuous end-expiratory lung volume and continuous noninvasive cardiac output. Dead space has slowly been gaining relevance in clinical monitoring and prognostic evaluation. Easy to measure dead space surrogates such as the ventilatory ratio have demonstrated a strong prognostic value in patients with acute respiratory failure.SummaryThe kinetics of carbon dioxide describe many relevant physiological processes. The clinical introduction of new ways of assessing respiratory and circulatory efficiency based on advanced analysis of CO2 kinetics are paving the road to a long-desired goal in clinical monitoring of critically ill patients: the integration of respiratory and circulatory monitoring during mechanical ventilation.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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