title: Accuracy of end-tidal CO2 capnometers in post-cardiac surgery patients during controlled mechanical ventilation.
abstract: BACKGROUND
  The determination of end-tidal carbon dioxide (etCO2) is very helpful in cardiac resuscitation for confirmation and monitoring of endotracheal tube placement and as an indicator of return of circulation and effectiveness of chest compressions. There is now also widespread use of capnometry on-site at emergency and trauma fields.
  
  
  OBJECTIVE
  We studied the accuracy and correlation of three capnometers (EMMA, Medtronic, and Evita) with partial pressure of arterial CO2 (PaCO2) measurements.
  
  
  METHODS
  The three capnometers were placed in-line in the ventilator tubing of the patient. Forty sedated and mechanically ventilated post-cardiac surgery patients were studied. Twenty consecutive etCO2 values were collected simultaneously from all three monitors while drawing an arterial blood sample. Paired sample t-test and Pearson correlation were used to compare the capnometers and their correlation with PaCO2.
  
  
  RESULTS
  The correlation of etCO2 measurements between all three capnometers was good (Emma vs. Evita: 0.874, Emma vs. Medtronic: 0.949, Evita vs. Medtronic: 0.878). The correlation of PaCO2 with the Evita is the lowest (0.671) as compared to the EMMA (0.693) and the Medtronic (0.727). The lowest dispersion of the difference between etCO2 and PaCO2 was seen in EMMA (3.30), the highest in Evita (3.98).
  
  
  CONCLUSIONS
  A good correlation between etCO2 and PaCO2 was shown with the three capnometers in the present study. However, etCO2 measurements were not valid to estimate PaCO2 in these patients. Therefore, capnometry cannot be used to replace serial blood gas analyses completely, but may be a good cardiopulmonary trend monitor and alerting system in catastrophic events.
authors: Department of Intensive Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors: Serge J H
authors: SJ
authors: Heines
authors: Ulrich
authors: U
authors: Strauch
authors: Paul M H J
authors: PM
authors: Roekaerts
authors: Bjorn
authors: B
authors: Winkens
authors: Dennis C J J
authors: DC
authors: Bergmans
mesh_terms: D000368:Aged; D001158:Arteries; D001784:Blood Gas Analysis; D019296:Capnography / Q000295:instrumentation*; D002245:Carbon Dioxide / Q000032:analysis* / Q000097:blood*; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010313:Partial Pressure; D011182:Postoperative Care / Q000295:instrumentation*; D012121:Respiration, Artificial
chemical_list: D002245:Carbon Dioxide