title: An abrupt reduction in end tidal carbon di oxide concentration in a mechanically ventilated patient in neurocritical care ward: a capnogram artifact.
abstract: In patients with normal lung and reasonable cardiac function such as head injury patients, the PETCo2can be used as a surrogate for partial pressure of Carbon dioxide (PaCO2) in mechanically ventilated patients. Thus early interpretation and accurate assessment of capnogram is crucial in neurocritical care patients. Here we present and discuss a scenario where in connection of a jet nebulizer to the ventilator lead to abrupt decrease in end tidal carbon dioxide leading to a diagnostic dilemma. Also this report highlights and discusses the importance of the proper placement of breathing circuit components to ensure accurate CO2readings in particular the use of a jet nebulizer.
authors.affiliation: Adjunct Tutor and Specialist, Department of Anaesthesia, Thumbay Hospital, Gulf Medical University, Ajman, United Arab Emirates. vini.leo24@gmail.com.
authors.forename: Byrappa
authors.initials: B
authors.lastname: Vinay
mesh_terms: D016477:Artifacts; D001784:Blood Gas Analysis / Q000379:methods*; D019296:Capnography / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis*; D002508:Cephalometry / Q000379:methods; D003422:Critical Care; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010313:Partial Pressure; D012121:Respiration, Artificial / Q000009:adverse effects; D012815:Signal Processing, Computer-Assisted; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide
keywords: Capnogram; False low end tidal carbon dioxide; Jet Nebulizer; Nebulization