Yıl: 2023 Cilt: 30 Sayı: 1 Sayfa Aralığı: 52 - 57 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2022.08.240 İndeks Tarihi: 03-04-2023

Role of capnography in safe sedation of vitrectomy patients

Öz:
Aim: To evaluate the efficiency of the capnography monitoring added to routine monitoring of oxygen desaturation, hypoxemia, and other vital parameters. Materials and Methods: 100 adult patients who had elective vitrectomy under sedation were included in this study. Patients were divided into “experiment”(capnography added to routine monitoring) and “control”(capnography not added to routine monitoring) groups. Hypoxemia, desaturation, tachycardia, bradycardia, and additional maneuvers for the airway were compared. Increase and decrease in end-tidal carbon dioxide (EtCO₂) levels, hypoxemia, desaturation, Integrated Pulmonary Index (IPI) levels requiring attention (5-7), and intervention (1-4) were determined in the experiment group, and frequencies of them were assessed. Results: Desaturation and bradycardia rates and counts in the experiment group were significantly lower than the control group. No significant difference was seen between groups in terms of hypoxemia, tachycardia, and additional maneuvers. 76%(38/50) of experiment group patients had decrease in EtCO₂, 10%(5/50) increase in EtCO₂, 38%(19/50) apnea, 52%(26/50) IPI levels requiring attention, 14%(7/50) IPI levels requiring intervention. Conclusion: With the addition of capnography to routine monitoring of sedated vitrectomy patients, oxygen desaturation and bradycardia can be less likely to occur, and with instant follow-up of the EtCO₂, apnea, and IPI levels, respiratory depression can be recognized before oxygen desaturation develops.
Anahtar Kelime: Vitrectomy Capnography Sedation End-tidal carbon dioxide EtCO2

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Schlag C, Wörner A, Wagenpfeil S, et al. Capnography im- proves detection of apnea during procedural sedation for per- cutaneous transhepatic cholangiodrainage. Can J Gastroenterol. 2013;27:582-6.
  • 2. Lightdale JR, Goldmann DA, Feldman HA, et al. Microstream capnography improves patient monitoring during moderate seda- tion: a randomized, controlled trial. Pediatrics. 2006;117:1170-8.
  • 3. Conway A, Douglas C, Sutherland JR. A systematic review of capnography for sedation. Anaesthesia. 2016;71:450-4.
  • 4. Ronen M, Weissbrod R, Overdyk FJ, Ajizian S. Smart respira- tory monitoring: clinical development and validation of the IPI™ (Integrated Pulmonary Index) algorithm. J Clin Monit Comput. 2017;31:435-42.
  • 5. Ishiwata T, Tsushima K, Terada J, et al. Efficacy of End-Tidal Capnography Monitoring during Flexible Bronchoscopy in Non- intubated Patients under Sedation: A Randomized Controlled Study. Respiration. 2018;96:355-62.
  • 6. Deitch K, Miner J, Chudnofsky CR, et al. Does end tidal CO2 monitoring during emergency department procedural se- dation and analgesia with propofol decrease the incidence of hy- poxic events? A randomized, controlled trial. Ann Emerg Med. 2010;55:258-64.
  • 7. Wall BF, Magee K, Campbell SG, Zed PJ. Capnography versus standard monitoring for emergency department proce- dural sedation and analgesia. Cochrane Database Syst Rev. 2017;3:CD010698.
  • 8. Campbell SG, Magee KD, Zed PJ, et al. End-tidal capnome- try during emergency department procedural sedation and anal- gesia: a randomized, controlled study. World J Emerg Med. 2016;7:13-8.
  • 9. Zongming J, Zhonghua C, Xiangming F. Sidestream capno- graphic monitoring reduces the incidence of arterial oxygen de- saturation during propofol ambulatory anesthesia for surgical abortion. Med Sci Monit. 2014;20:2336-42.
  • 10. Klare P, Reiter J, Meining A, et al. Capnographic monitoring of midazolam and propofol sedation during ERCP: a randomized controlled study (EndoBreath Study). Endoscopy. 2016;48:42- 50.
  • 11. Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay. Circulation. 2018.
  • 12. Qadeer MA, Vargo JJ, Dumot JA, et al. Capnographic moni- toring of respiratory activity improves safety of sedation for en- doscopic cholangiopancreatography and ultrasonography. Gas- troenterology. 2009;136:1568-76.
  • 13. Waugh JB, Epps CA, Khodneva YA. Capnography enhances surveillance of respiratory events during procedural sedation: a meta-analysis. J Clin Anesth. 2011;23:189-96.
  • 14. Lin TY, Fang YF, Huang SH, et al. capnography monitoring the hypoventilation during the induction of bronchoscopic sedation: A randomized controlled trial. Sci Rep. 2017;7:8685.
  • 15. Ishiwata T, Tsushima K, Fujie M, et al. End-tidal capno- graphic monitoring to detect apnea episodes during flexible bron- choscopy under sedation. BMC Pulm Med. 2017;17:7.
  • 16. Vargo JJ, Zuccaro G Jr, Dumot JA, et al. Automated graphic as- sessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depres- sion during therapeutic upper endoscopy. Gastrointest Endosc. 2002;55:826-31.
  • 17. Riphaus A, Wehrmann T, Kronshage T, et al. Clinical value of the Integrated Pulmonary Index(®) during sedation for inter- ventional upper GI-endoscopy: A randomized, prospective tri- center study. Dig Liver Dis. 2017;49:45-9.
  • 18. Kaur R, Vines DL, Liu L, Balk RA. Role of Integrated Pul- monary Index in Identifying Extubation Failure. Respir Care. 2017;62:1550-6.
APA Cetinkaya Ozpar S, Yerebakan S, Kahveci F (2023). Role of capnography in safe sedation of vitrectomy patients. , 52 - 57. 10.5455/annalsmedres.2022.08.240
Chicago Cetinkaya Ozpar Sinem,Yerebakan Selcan,Kahveci Ferda Sohret Role of capnography in safe sedation of vitrectomy patients. (2023): 52 - 57. 10.5455/annalsmedres.2022.08.240
MLA Cetinkaya Ozpar Sinem,Yerebakan Selcan,Kahveci Ferda Sohret Role of capnography in safe sedation of vitrectomy patients. , 2023, ss.52 - 57. 10.5455/annalsmedres.2022.08.240
AMA Cetinkaya Ozpar S,Yerebakan S,Kahveci F Role of capnography in safe sedation of vitrectomy patients. . 2023; 52 - 57. 10.5455/annalsmedres.2022.08.240
Vancouver Cetinkaya Ozpar S,Yerebakan S,Kahveci F Role of capnography in safe sedation of vitrectomy patients. . 2023; 52 - 57. 10.5455/annalsmedres.2022.08.240
IEEE Cetinkaya Ozpar S,Yerebakan S,Kahveci F "Role of capnography in safe sedation of vitrectomy patients." , ss.52 - 57, 2023. 10.5455/annalsmedres.2022.08.240
ISNAD Cetinkaya Ozpar, Sinem vd. "Role of capnography in safe sedation of vitrectomy patients". (2023), 52-57. https://doi.org/10.5455/annalsmedres.2022.08.240
APA Cetinkaya Ozpar S, Yerebakan S, Kahveci F (2023). Role of capnography in safe sedation of vitrectomy patients. Annals of Medical Research, 30(1), 52 - 57. 10.5455/annalsmedres.2022.08.240
Chicago Cetinkaya Ozpar Sinem,Yerebakan Selcan,Kahveci Ferda Sohret Role of capnography in safe sedation of vitrectomy patients. Annals of Medical Research 30, no.1 (2023): 52 - 57. 10.5455/annalsmedres.2022.08.240
MLA Cetinkaya Ozpar Sinem,Yerebakan Selcan,Kahveci Ferda Sohret Role of capnography in safe sedation of vitrectomy patients. Annals of Medical Research, vol.30, no.1, 2023, ss.52 - 57. 10.5455/annalsmedres.2022.08.240
AMA Cetinkaya Ozpar S,Yerebakan S,Kahveci F Role of capnography in safe sedation of vitrectomy patients. Annals of Medical Research. 2023; 30(1): 52 - 57. 10.5455/annalsmedres.2022.08.240
Vancouver Cetinkaya Ozpar S,Yerebakan S,Kahveci F Role of capnography in safe sedation of vitrectomy patients. Annals of Medical Research. 2023; 30(1): 52 - 57. 10.5455/annalsmedres.2022.08.240
IEEE Cetinkaya Ozpar S,Yerebakan S,Kahveci F "Role of capnography in safe sedation of vitrectomy patients." Annals of Medical Research, 30, ss.52 - 57, 2023. 10.5455/annalsmedres.2022.08.240
ISNAD Cetinkaya Ozpar, Sinem vd. "Role of capnography in safe sedation of vitrectomy patients". Annals of Medical Research 30/1 (2023), 52-57. https://doi.org/10.5455/annalsmedres.2022.08.240