Capnography Use During Intubation and Cardiopulmonary Resuscitation in the Pediatric Emergency Department
| Autor: | Aaron Donoghue, James Dodington, Melissa L. Langhan, Adam Bullock |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Pediatric advanced life support Return of spontaneous circulation Article Young Adult 03 medical and health sciences 0302 clinical medicine Capnography 030225 pediatrics Acute care Intubation Intratracheal Humans Medicine Intubation Cardiopulmonary resuscitation Child Intensive care medicine Monitoring Physiologic Retrospective Studies medicine.diagnostic_test business.industry Infant 030208 emergency & critical care medicine Retrospective cohort study General Medicine Emergency department Cardiopulmonary Resuscitation Child Preschool Pediatrics Perinatology and Child Health Emergency Medicine Female Emergency Service Hospital business |
| Zdroj: | Pediatric Emergency Care. 33:457-461 |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0000000000000813 |
| Popis: | Over the last 30 years there has been a rapid rise in publications related to capnography, or continuous end-tidal carbon dioxide (ETCO2) monitoring, with a parallel increase in the number of patient applications for this device.1 Importantly, capnography has been studied in the setting of intubation and cardiopulmonary resuscitation (CPR) and shown to provide benefits to both patients and providers.2 In the setting of intubation, capnography is the ‘gold-standard’ method for confirmation of endotracheal tube (ETT) placement in the trachea; it also accurately detects ETT dislodgement and may decrease the frequency of inadvertent hypo- and hyperventilation.3-7 During CPR, capnography may correlate with pulmonary blood flow as a measure of the effectiveness of chest compressions, can be an early indicator of the return of spontaneous circulation (ROSC), and may be useful in predicting mortality.8-10 With this growing body of evidence, the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science as well as the American Heart Association (AHA) updated their guidelines for both Adult and Pediatric Advanced Life Support in 2010 to include recommendations for capnography use during these critical events.11-13 The new guidelines recommended the routine use of quantitative waveform capnography for both intubation and during CPR.11-13 Since capnography is the most reliable method to confirm placement of the ETT, this method was given a class I recommendation for all hospital settings.12 In the event of CPR, capnography can improve the quality of chest compressions by serving as a guide to effective compressions and reduce interruptions by identifying ROSC without frequent pauses for pulse checks (Class IIa). Since these recommendations have been released, it is unclear if they are being adhered to for children. Overall, there is little data documenting how capnography is being used in children, particularly in the emergency department (ED). Our primary objectives were to determine how often capnography is being used during critical events and if publication of the updated AHA guidelines resulted in an increase in use of capnography. Our secondary objective was to examine associations between patient characteristics and capnography use among these patients in the pediatric acute care setting. |
| Databáze: | OpenAIRE |
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