Respiratory care clinics of North America
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Capnography measures exhaled carbon dioxide and is most useful when applied directly to patient care. This is in circumstances of detecting misplacement of the tracheal tube, dysfunction of respiratory apparatuses, detection of abnormal lung function, successful cardiopulmonary resuscitation, and trending of deadspace changes. The least reliable application is to reflect alveolar ventilation (PaCO2). ⋯ The use of capnography in patients with severe respiratory failure should be applied with careful reflection. The increased V/Q mismatch that is consistent with a widened P(a-ET) gradient, as well as worsening hypercapnea with increased peripheral carbon dioxide production, can lead to erroneous PETCO2 values. Capnography may be least useful in the sickest patients.
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Respir Care Clin N Am · Sep 1995
ReviewTranscutaneous measurement of partial pressure of oxygen and carbon dioxide.
Transcutaneous monitoring is noninvasive and relatively simple to use. In neonates and small infants, this monitoring technique may provide very useful clinical information. ⋯ Because transcutaneous gases depend on skin perfusion, however, it may be useful in monitoring tissue perfusion, especially in patients with peripheral vascular disease and tissue flaps. The heating of the monitoring probe necessitates frequent site changes to avoid thermal injury, which make it more labor intensive than other noninvasive monitoring methods.
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Pulse oximetry is a reliable, noninvasive, easy to use means of continuously determining arterial oxygen saturation in virtually any setting. This article details the historical and technical development of this monitor; reviews the literature on application, accuracy, and response; and presents an overview of future advances.