PMID: 11907398Mar 22, 2002Paper

Should one rely on capnometry when a capnogram is not seen?

Journal of Neurosurgical Anesthesiology
Ajay KumarPrabhat Kumar Sinha

Abstract

Capnography is one of the basic monitoring techniques in day-to-day anesthesia practice that provides information not only regarding the patient's ventilation, circulation, and metabolism, but also regarding proper functioning of a closed-circle system. The authors report a case in which after endotracheal intubation the end-tidal capnometric reading rose very high, but the capnogram was not seen on the monitor. The unexpectedly high capnometric reading with absent waveform during intermittent positive pressure ventilation without any apparent cause and consequent delayed institution of corrective measures resulted in severe brain bulge. There was severe hypercarbia as a result of a malfunctioning expiratory unidirectional valve that allowed rebreathing. Retrospective retrieval of data showed that a fraction of inspired carbon dioxide was also high and the baseline was raised beyond the usual range of 0 to 40 mm Hg, giving the impression of an absent waveform on the existing scale. In conclusion, one should keep in mind the possibility of expiratory valve malfunction resulting from dislodgment while wheeling the anesthesia machine, the view becoming obscured as a result of condensation of water vapor on the under surface of the...Continue Reading

References

Feb 1, 1988·Anaesthesia and Intensive Care·P E Lillie, J G Roberts
Sep 1, 1988·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·L S Berman, S T Pyles
Apr 1, 1958·Canadian Anaesthetists' Society Journal·J H KERR, J L EVERS
Jan 1, 1964·The American Journal of Physiology·M REIVICH

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Citations

Mar 16, 2006·Journal of the American Veterinary Medical Association·Kirsten Wegner, Luisito Pablo

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