Capnometry in the spontaneously breathing patient

Abstract

PURPOSE OF REVIEW: Capnography has been used in the operating room by anesthesiologists for over a decade. Along with pulse oximetry, it has reduced anesthesia-related morbidity and mortality. Traditionally, capnography has been used to confirm the placement of the endotracheal tube. This review looks into the literature for an update on the use of capnography in the spontaneously breathing patient. RECENT FINDINGS: Several studies support the additional safety afforded by the use of capnography in patients undergoing sedation for procedures in various situations outside the operating room. Capnography has been used as an aid in the diagnosis of pulmonary embolism and sleep-related disorders, as a continuous monitor of metabolic status of pediatric patients with diabetic ketoacidosis and, along with pulse oximetry, in lung-function laboratories to estimate blood gases. SUMMARY: Capnography has become a mandatory or recommended monitoring tool in the practice of anesthesiology. It is making inroads into other medical specialties as a monitoring and diagnostic tool. The use of this technology by non-anesthesiologists will continue to increase. In the opinion of the authors capnography should be used in all cases requiring sedation either in or out of the operating room.