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Pediatric capnography

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https://read.qxmd.com/read/31073486/current-use-of-invasive-and-noninvasive-monitors-in-academic-pediatric-intensive-care-units
#1
Awni M Al-Subu, Kyle J Rehder, George Ofori-Amanfo, David A Turner
To describe the current use of noninvasive monitoring compared with traditional invasive monitoring in Pediatric Critical Care Medicine (PCCM) accredited fellowship programs in the United States. A web-based survey with the primary aim of describing the utilization of noninvasive monitoring compared with invasive monitoring was distributed to PCCM program directors (PDs) at the 64 accredited fellowship training programs. Questions focused on demographics and the utilization of invasive and noninvasive monitoring for specific patient populations and disease states...
September 2018: Journal of Pediatric Intensive Care
https://read.qxmd.com/read/30993739/diagnostic-accuracy-of-a-3-point-ultrasound-protocol-to-detect-esophageal-or-endobronchial-mainstem-intubation-in-a-pediatric-emergency-department
#2
Takaaki Mori, Osamu Nomura, Yusuke Hagiwara, Nobuaki Inoue
OBJECTIVES: The aim of this study was to evaluate the diagnostic accuracy of the 3-point approach with ultrasonography for confirming endotracheal tube (ETT) placement in pediatric patients. METHODS: This was a prospective study conducted at a tertiary care center in Japan between March 2014 and March 2016. Children aged 0 to 18 years requiring endotracheal intubation in our emergency department (ED) who underwent ultrasonography for confirming ETT placement were enrolled...
April 16, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://read.qxmd.com/read/30820870/two-site-regional-oxygen-saturation-and-capnography-monitoring-during-resuscitation-after-cardiac-arrest-in-a-swine-pediatric-ventricular-fibrillatory-arrest-model
#3
Awni M Al-Subu, Timothy A Hacker, Jens C Eickhoff, George Ofori-Amanfo, Marlowe W Eldridge
To investigate the use of two-site regional oxygen saturations (rSO2 ) and end tidal carbon dioxide (EtCO2 ) to assess the effectiveness of resuscitation and return of spontaneous circulation (ROSC). Eight mechanically ventilated juvenile swine underwent 28 ventricular fibrillatory arrests with open cardiac massage. Cardiac massage was administered to achieve target pulmonary blood flow (PBF) as a percentage of pre-cardiac arrest baseline. Non-invasive data, including, EtCO2 , cerebral rSO2 (C-rSO2 ) and renal rSO2 (R-rSO2 ) were collected continuously...
February 28, 2019: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/30801831/the-utility-of-the-pretracheal-stethoscope-in-detecting-ventilatory-abnormalities-during-propofol-sedation-in-children
#4
Juan P Boriosi, Qianqian Zhao, Ashley Preston, Gregory A Hollman
BACKGROUND: Monitoring of ventilation with capnography or a stethoscope is recommended because the detection of ventilatory abnormalities can be significantly delayed by the use of pulse oximetry alone in patients receiving supplemental oxygen. The aim of this study was to evaluate the diagnostic performance of the pretracheal stethoscope with pulse oximetry and capnography in detecting adverse respiratory events during propofol sedation in non-intubated children. We hypothesized that use of the pretracheal stethoscope would facilitate earlier detection of adverse respiratory events...
February 23, 2019: Paediatric Anaesthesia
https://read.qxmd.com/read/30601348/use-of-capnography-and-cardiopulmonary-resuscitation-feedback-devices-among-prehospital-advanced-life-support-providers
#5
Cyril Sahyoun, Christina Siliciano, David Kessler
BACKGROUND: Capnography and cardiopulmonary resuscitation (CPR) feedback devices have been shown to improve resuscitation outcomes, with the American Heart Association recommending their use during advanced life support (ALS). Little is known about the availability of these devices, their protocoled use, and the attitudes toward them in the prehospital setting. OBJECTIVES: The objectives of this study were to assess the availability of capnography and CPR feedback devices among prehospital ALS agencies in New York State (NYS), to describe the protocoled use of these devices, and to evaluate the attitudes of providers toward the use of these devices...
December 27, 2018: Pediatric Emergency Care
https://read.qxmd.com/read/30507754/an-update-on-end-tidal-co2-monitoring
#6
REVIEW
Samuel T Selby, Thomas Abramo, Nicholas Hobart-Porter
End-tidal CO2 (ETCO2) monitoring is not a new modality in the pediatric emergency department (PED) and emergency department. It is the standard of care during certain procedures such as intubations and sedations and can be used in variety of clinical situations. However, ETCO2 may be underused in the PED setting. The implementation of ETCO2 monitoring may be accomplished many ways, but a foundation of capnography principles specifically in ventilation, cardiac output, and current literature regarding its application is essential to successful implementation...
December 2018: Pediatric Emergency Care
https://read.qxmd.com/read/30133920/correlation-between-minute-carbon-dioxide-elimination-and-pulmonary-blood-flow-in-single-ventricle-patients-after-stage-1-palliation-and-2-ventricle-patients-with-intracardiac-shunts-a-pilot-study
#7
Awni Al-Subu, Edmund Jooste, Christoph P Hornik, Gregory A Fleming, Ira M Cheifetz, George Ofori-Amanfo
BACKGROUND: Assessment of pulmonary blood flow and cardiac output is critical in the postoperative management of patients with single-ventricle physiology or 2-ventricle physiology with intracardiac shunting. Currently, such hemodynamic data are only obtainable by invasive procedures, such as cardiac catheterization or the use of a pulmonary artery catheter. Ready availability of such information, especially if attainable noninvasively, could be a valuable addition to postoperative management...
July 2018: Paediatric Anaesthesia
https://read.qxmd.com/read/30097185/-anesthesia-and-perioperative-challenges-for-surgical-separation-of-thoraco-omphalopagus-twins-case-report
#8
Milton Halyson Benevides de Freitas, Luciana Cavalcanti Lima, Tania Cursino de Menezes Couceiro, Maria Célia Ferreira da Costa, Márcio Handerson Benevides de Freitas
BACKGROUND AND OBJECTIVES: Conjoined twins are monozygotic twins physically joined at some part of the body. This is a rare phenomenon, estimated between 1:50,000 to 1:200,000 births. The objective of this report is to present the anesthetic management and the perioperative challenges for a separation surgery. CASE REPORT: Thoraco-omphalopagus twins were diagnosed by ultrasound and were followed by the fetal medicine team of the service. After 11hours of cesarean, the pediatric surgical team chose to separate the twins...
August 7, 2018: Revista Brasileira de Anestesiologia
https://read.qxmd.com/read/29680425/prevalence-and-characteristics-of-sleep-disordered-breathing-in-familial-dysautonomia
#9
Kanwaljit Singh, Jose-Alberto Palma, Horacio Kaufmann, Nataliya Tkachenko, Lucy Norcliffe-Kaufmann, Christy Spalink, Mikhail Kazachkov, Sanjeev V Kothare
OBJECTIVE: Familial dysautonomia (FD) is an autosomal recessive disorder characterized by impaired development of sensory and afferent autonomic nerves. Untreated sleep-disordered breathing (SDB) has been reported to increase the risk of sudden unexpected death in FD. We aimed to describe the prevalence and characteristics of SDB in FD. PATIENTS/METHODS: Seventy-five patients with FD (20 adults and 55 children) underwent in-lab polysomnography, including peripheral capillary oxygen saturation (SpO2 ) and end-tidal capnography (EtCO2 ) measurements...
May 2018: Sleep Medicine
https://read.qxmd.com/read/29169819/use-of-capnography-to-optimize-procedural-sedation-in-the-emergency-department-pediatric-population
#10
REVIEW
Leonie Rose Bovino, Christina Brainard, Kristen Beaumier, Victoria Concetti, Nicole Lefurge, Emily Mittelstadt, Tabea Wilson, Melissa L Langhan
No abstract text is available yet for this article.
March 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://read.qxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#11
MULTICENTER STUDY
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
February 2018: Pediatric Critical Care Medicine
https://read.qxmd.com/read/29117819/role-of-ultrasound-in-confirmation-of-endotracheal-tube-in-neonates-a-review
#12
REVIEW
Deepak Sharma, Seyyed Ahmad Tabatabaii, Nazanin Farahbakhsh
Tracheal intubation (TI) is a commonly done procedure in neonatal intensive care unit and delivery room during resuscitation. The confirmation of endotracheal tube (ETT) position should be done quickly as tube malposition is associated with various serious adverse outcomes like hypoxemia, right upper lobe collapse, atelectasis, air leak syndromes and esophageal intubation. ETT position can be confirmed by various methods like clinical sign, chest radiography, capnography, external digital tracheal palpation, ultrasonography (USG), respiratory function monitor, video-laryngoscope and fiberoptic devices...
April 2019: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/29084068/can-providers-use-clinical-skills-to-assess-the-adequacy-of-ventilation-in-children-during-bag-valve-mask-ventilation
#13
Heather J Becker, Melissa L Langhan
OBJECTIVE: Bag-valve mask (BVM) ventilation requires both manual skill and clinical assessment of minute ventilation. Subjective factors can make supplying appropriate ventilation difficult. Capnography is not routinely used when ventilating nonintubated patients. Our objective was to determine if providers were able to maintain normal capnography values with BVM ventilation in pediatric patients based on clinical skills alone. METHODS: Providers (nurses, residents, and fellows) delivered 2 minutes of BVM respiratory support to healthy children during induction of anesthesia for elective surgery...
October 27, 2017: Pediatric Emergency Care
https://read.qxmd.com/read/28460704/continuous-capnography-in-pediatric-intensive-care
#14
REVIEW
Christine M Riley
Capnography or end-tidal carbon dioxide (Etco2 ) monitoring has a variety of uses in the pediatric intensive care setting. The ability to continuously measure exhaled carbon dioxide can provide vital information about airway, breathing, and circulation in critically ill pediatric patients. Capnography has diagnosis-specific applications for pediatric patients with congenital heart disease, reactive airway disease, neurologic emergencies, and metabolic derangement. This modality allows for noninvasive monitoring and has become the standard of care...
June 2017: Critical Care Nursing Clinics of North America
https://read.qxmd.com/read/28448390/comparison-of-postoperative-respiratory-monitoring-by-acoustic-and-transthoracic-impedance-technologies-in-pediatric-patients-at-risk-of-respiratory-depression
#15
MULTICENTER STUDY
Mario Patino, Megan Kalin, Allison Griffin, Abu Minhajuddin, Lili Ding, Timothy Williams, Stacey Ishman, Mohamed Mahmoud, C Dean Kurth, Peter Szmuk
BACKGROUND: In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. METHODS: Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia...
June 2017: Anesthesia and Analgesia
https://read.qxmd.com/read/28413621/recent-advances-in-pediatric-ventilatory-assistance
#16
REVIEW
Nicolas Nardi, Guillaume Mortamet, Laurence Ducharme-Crevier, Guillaume Emeriaud, Philippe Jouvet
In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since these complications may lead to higher mortality and prolonged length of stay in intensive care units. Different physiological measurements, such as esophageal pressure, electrical activity of the diaphragm, and volumetric capnography, may be useful objective tools to help guide ventilator assistance...
2017: F1000Research
https://read.qxmd.com/read/28288298/detection-of-respiratory-adverse-events-in-pediatric-dental-patients-sedated-with-0-75mg-kg-of-midazolam-and-oxygen-by-continuous-pretracheal-auscultation-a-prospective-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Mostafa Somri, Ibrahim Matter, Christopher Hadjittofi, Naser Hoash, Bian Moaddi, Johnny Kharouba, Constantinos A Parisinos, Benjamin Peretz
PURPOSE: Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation...
2017: Journal of Clinical Pediatric Dentistry
https://read.qxmd.com/read/28244630/implementation-of-nap4-emergency-airway-management-recommendations-in-a-quaternary-level-pediatric-hospital
#18
REVIEW
Elliot Long, Domenic Cincotta, Joanne Grindlay, Anastasia Pellicano, Michael Clifford, Stefan Sabato
Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error...
May 2017: Paediatric Anaesthesia
https://read.qxmd.com/read/28177565/the-impact-of-capnography-monitoring-among-children-and-adolescents-in-the-postanesthesia-care-unit-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Melissa L Langhan, Fang-Yong Li, J Lance Lichtor
BACKGROUND: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression. AIM: We hypothesized that children monitored with capnography would have more frequent staff interventions and fewer adverse events than children monitored with pulse oximetry alone...
April 2017: Paediatric Anaesthesia
https://read.qxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#20
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigsknecht, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2 ) or saturations (SpO2 ) to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n = 21)...
June 2017: Pediatric Research
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