6533b85cfe1ef96bd12bc086

RESEARCH PRODUCT

Measurement of end-tidal carbon dioxide in spontaneously breathing patients in the pre-hospital setting. A prospective evaluation of 350 patients

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Monitoring of end-tidal carbon dioxide (EtCO(2)) is good clinical practice in the patient who is intubated and ventilated. This study investigated the EtCO(2) values in spontaneously breathing patients treated in a physician-staffed mobile intensive care unit (MICU). This article also discusses whether EtCO(2) monitoring may have an influence on therapeutic decisions by emergency physicians by providing additional information.Over a period of 6 months, 350 spontaneously breathing patients (162 males, 137 females) were treated and transported in our MICU and monitored using a LifePak 12 monitor (EtCO(2), respiratory rate, pO(2), blood pressure, heart rate). Only 299 were enrolled in the study.Pathological EtCO(2) values were detected in 19 patients (6.3%). EtCO(2) levels of55 mmHg (7.3 kPa) were found in nine of 12 (75%) patients with asthma, in one of 23 patients with hypoglycaemia (4.3%), and in all patients with subarachnoid hemorrhage, acute seizures and drug intoxications. With the exception of the asthma patients, all patients had an initial Glasgow Coma Score8. EtCO(2) levels20 mmHg (2.7 kPa) were found in all patients with hyperventilation or shock due to volume deficiency. Errors in EtCO(2) measurement occurred in 5% of cases.Although EtCO(2) monitoring may be a useful additional variable in spontaneously breathing patients. Consideration of the respective disease and the cost to benefit ratio suggests that this method should only be used for selected indications.