title: Capnography in patients with severe neurological impairment.
abstract: Respiratory disease is a common reason for hospitalization and mortality in persons with severe intellectual and developmental disability. Capnography is the measurement and numerical display of end-tidal carbon dioxide (EtCO2). This was a prospective, case controlled, cross sectional study to assess differences of baseline EtCO2 values between neurologically impaired patients and healthy individuals. 86 neurologically impaired patients were evaluated in the study group. Their mean age ± SD was 25.65 ± 10.48 years with 41% males. 53 healthy children and young adults were evaluated in the control group. Their mean age ± SD was 21.95 ± 10.38 years with 54.7% males. Patients with severe neurological impairment had higher baseline EtCO2 values than healthy individuals. Kyphoscoliosis and the use of antipsychotic drugs were the major factors to increase EtCO2 levels. Knowing the patient's baseline EtCO2 value, as well as baseline oximetry, could guide treatment decisions, when assessing the patient's oxygenation and ventilation during acute respiratory illness, and can potentially prevent unnecessary laboratory and imaging investigations as well as over treatment. Future research can shed light on the utility of capnometry and clinical implications of higher baseline EtCO2 values among neurologically impaired patients.
authors.affiliation: Department of Pediatrics B, Meyer Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Jacob
authors.affiliation: Department of Pediatrics B, Meyer Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Annette
authors.initials: A
authors.lastname: Nelkenbaum
authors.affiliation: Pediatric Division, Hadassah Hebrew University Medical Center, Mt Scopus Campus, Jerusalem, Israel; National Institute of Child Health and Human Development, Office of the Medical Director, Health Services, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services, Jerusalem, Israel; Kentucky Children's Hospital, University of Kentucky, Lexington, United States. Electronic address: jmerrick@zahav.net.il.
authors.forename: Joav
authors.initials: J
authors.lastname: Merrick
authors.affiliation: Department of Pediatrics B, Meyer Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Riva
authors.initials: R
authors.lastname: Brik
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D019296:Capnography; D002245:Carbon Dioxide / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities; D005260:Female; D006801:Humans; D008607:Intellectual Disability; D007738:Kyphosis; D008297:Male; D010092:Oximetry; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012307:Risk Factors; D012600:Scoliosis; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D002245:Carbon Dioxide
keywords: Capnography; Developmental disability; Intellectual disability; Neurological impairment; Respiratory illness