Capnography and Critical Care Transport

Utility of a novel quantitative handheld microstream capnometer during transport of critically ill children

Am J Emerg Med. 2006 May;24(3):302-7. Singh S, Allen WD Jr, Venkataraman ST, Bhende MS. Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA

A partial abstract:

RESULTS: Fifty patients comprised the study group, ages birth to 15.3 years (median, 4 months) and weighing 1.63 to 70 kg (median, 5.25 kg). Nineteen patients were transported by ground ambulance and 31 by rotorcraft. The capnometer confirmed ETT position during transport in all patients. The audiovisual alarm of the capnometer immediately detected a ventilator disconnection from the ETT during one air transport. The size of the device was evaluated as "just right" in 37 of 50 transports, "easy to secure" in 46 of 50, and "useful" in all 50 transports. There were no false-negative readings, occlusion, or kinking of tubing during transport. NPB-75 was specifically useful for setting optimal ventilatory support in 2 patients with raised intracranial pressure who required controlled ventilation. Furthermore, it confirmed adequate ventilation when the ventilator falsely detected a low respiratory rate in a newborn with a congenital heart disease for whom pulse oximetry was unreliable. The ETco(2) waveform detected air trapping in 2 ventilated asthmatic patients. CONCLUSIONS: This lightweight microstream capnometer with a 4-hour battery life and audiovisual alarms functioned well in the prehospital setting. It provided both quantitative and graphic real-time detection of ETco(2) in intubated patients, which was of critical importance for the optimal management of patients during transport.

Bottom Line: This study showed the utility of using a small handheld capnometer, a device, which measured only the ETCO2 number during transport of critical care patients.