viernes, 13 de abril de 2012

National Guideline Clearinghouse | Capnography/capnometry during mechanical ventilation: 2011. || American Association for Respiratory Care

National Guideline Clearinghouse | Capnography/capnometry during mechanical ventilation: 2011.

Guideline Title
Capnography/capnometry during mechanical ventilation: 2011.
Bibliographic Source(s)
Walsh BK, Crotwell DN, Restrepo RD. Capnography/capnometry during mechanical ventilation: 2011. Respir Care 2011 Apr;56(4):503-9. PubMed External Web Site Policy
Guideline Status
This is the current release of the guideline.
This guideline updates a previous version: McArthur CD. AARC clinical practice guideline. Capnography/capnometry during mechanical ventilation--2003 revision & update. Respir Care 2003 May;48(5):534-9.

Respir Care. 2011 Apr;56(4):503-9. Epub 2011 Jan 21.

Capnography/Capnometry during mechanical ventilation: 2011.


Respiratory Care Department, Children's Medical Center, Dallas, Texas, USA.


We searched the MEDLINE, CINAHL, and Cochrane Library databases for articles published between January 1990 and November 2010. The update of this clinical practice guideline is based on 234 clinical studies and systematic reviews, 19 review articles that investigated capnography/capnometry during mechanical ventilation, and the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The following recommendations are made following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scoring system: (1) Continuous-waveform capnography is recommended, in addition to clinical assessment to confirm and monitor correct placement of an endotracheal tube. (2) If waveform capnography is not available, a non-waveform exhaled CO(2) monitor, in addition to clinical assessment, is suggested as the initial method for confirming correct tube placement in a patient in cardiac arrest. (3) End-tidal CO(2) (P(ETCO(2))) is suggested to guide ventilator management. (4) Continuous capnometry during transport of the mechanically ventilated patients is suggested. (5) Capnography is suggested to identify abnormalities of exhaled air flow. (6) Volumetric capnography is suggested to assess CO(2) elimination and the ratio of dead-space volume to tidal volume (V(D)/V(T)) to optimize mechanical ventilation. (7) Quantitative waveform capnography is suggested in intubated patients to monitor cardiopulmonary quality, optimize chest compressions, and detect return of spontaneous circulation during chest compressions or when rhythm check reveals an organized rhythm.

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