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Research ArticleAARC Clinical Practice Guideline

Capnography/Capnometry During Mechanical Ventilation: 2011

Brian K Walsh, David N Crotwell and Ruben D Restrepo
Respiratory Care April 2011, 56 (4) 503-509; DOI: https://doi.org/10.4187/respcare.01175
Brian K Walsh
Respiratory Care Department, Children's Medical Center, Dallas, Texas.
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David N Crotwell
Department of Respiratory Care, Seattle Children's Hospital and Regional Medical Center, Seattle, Washington.
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Ruben D Restrepo
Department of Respiratory Care, The University of Texas Health Sciences Center at San Antonio, San Antonio, Texas.
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Abstract

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 CO2 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 CO2 (PETCO2) 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 CO2 elimination and the ratio of dead-space volume to tidal volume (VD/VT) 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.

  • capnography
  • capnometry
  • colorimetric CO2
  • end-tidal carbon dioxide
  • volumetric CO2

Footnotes

  • Correspondence: Ruben D Restrepo MD RRT FAARC, Department of Respiratory Care, The University of Texas Health Sciences Center at San Antonio, 7703 Floyd Curl Drive, MSC 6248, San Antonio TX 78229. E-mail: restrepor{at}uthscsa.edu.
  • Copyright © 2011 by Daedalus Enterprises Inc.
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Respiratory Care: 56 (4)
Respiratory Care
Vol. 56, Issue 4
1 Apr 2011
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Capnography/Capnometry During Mechanical Ventilation: 2011
Brian K Walsh, David N Crotwell, Ruben D Restrepo
Respiratory Care Apr 2011, 56 (4) 503-509; DOI: 10.4187/respcare.01175

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Capnography/Capnometry During Mechanical Ventilation: 2011
Brian K Walsh, David N Crotwell, Ruben D Restrepo
Respiratory Care Apr 2011, 56 (4) 503-509; DOI: 10.4187/respcare.01175
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Keywords

  • capnography
  • capnometry
  • colorimetric CO2
  • end-tidal carbon dioxide
  • volumetric CO2

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