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  • Print publication year: 2011
  • Online publication date: August 2011

15 - Capnography in non-invasive positive pressure ventilation

from 1 - Ventilation


The usually more controlled circumstances of airway management in the operating room (OR) often provide better conditions, better monitoring, and more experienced personnel, particularly when a problem occurs, than is available in other critical care environments or the emergency department. While the detection of CO2 by capnography after completion of a difficult intubation procedure may suggest success, it may more precisely indicate only that the tube tip is somewhere in the respiratory path, although perhaps not exactly where the intubationist desires. A capnography pattern indicating declining CO2 in each subsequent breath over several breaths will help identify esophageal intubation. Unilateral pathophysiologic conditions that cause unilateral hypoventilation or high airway resistances would result in a biphasic waveform. Many techniques to facilitate blind nasal tracheal intubation use the detection of significant exhaled gas flow from a spontaneously breathing patient to indicate the proximity of the tube tip to the glottic opening.


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