Capnography-An Essential Monitor, Everywhere: A Narrative Review.

Autor:	Wollner EA; From the Department of Anaesthesia and Perioperative Medicine, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.; Center for Health Equity in Surgery and Anesthesia (CHESA), University of California, San Francisco, California., Nourian MM; Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee., Bertille KK; Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso., Wake PB; School of Medicine and Health Sciences, University of Papua New Guinea., Lipnick MS; Department of Anesthesia and Perioperative Medicine, Center for Health Equity in Surgery and Anesthesia (CHESA), University of California, San Francisco, California., Whitaker DK; Department of Anaesthesia and Intensive Care, Manchester Royal Infirmary, United Kingdom.
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2023 Nov 01; Vol. 137 (5), pp. 934-942. Date of Electronic Publication: 2023 Oct 20.
DOI:	10.1213/ANE.0000000000006689
Abstrakt:	Capnography is now recognized as an indispensable patient safety monitor. Evidence suggests that its use improves outcomes in operating rooms, intensive care units, and emergency departments, as well as in sedation suites, in postanesthesia recovery units, and on general postsurgical wards. Capnography can accurately and rapidly detect respiratory, circulatory, and metabolic derangements. In addition to being useful for diagnosing and managing esophageal intubation, capnography provides crucial information when used for monitoring airway patency and hypoventilation in patients without instrumented airways. Despite its ubiquitous use in high-income-country operating rooms, deaths from esophageal intubations continue to occur in these contexts due to incorrect use or interpretation of capnography. National and international society guidelines on airway management mandate capnography's use during intubations across all hospital areas, and recommend it when ventilation may be impaired, such as during procedural sedation. Nevertheless, capnography's use across high-income-country intensive care units, emergency departments, and postanesthesia recovery units remains inconsistent. While capnography is universally used in high-income-country operating rooms, it remains largely unavailable to anesthesia providers in low- and middle-income countries. This lack of access to capnography likely contributes to more frequent and serious airway events and higher rates of perioperative mortality in low- and middle-income countries. New capnography equipment, which overcomes cost and context barriers, has recently been developed. Increasing access to capnography in low- and middle-income countries must occur to improve patient outcomes and expand universal health care. It is time to extend capnography's safety benefits to all patients, everywhere. Competing Interests: Conflicts of Interest: See Disclosures at the end of the article. (Copyright © 2023 International Anesthesia Research Society.)
Databáze:	MEDLINE
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