CHEST Journal Volume issue 2016 [doi 10.1378%2Fchest.15-1369] Nassar, Boulos S._ Schmidt, Gregory A. -- Capnography During Critical Illness.pdf

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  • 8/18/2019 CHEST Journal Volume issue 2016 [doi 10.1378%2Fchest.15-1369] Nassar, Boulos S._ Schmidt, Gregory A. -- Capn…

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     Accepted Manuscript

    Capnography During Critical Illness

    Boulos S. Nassar, MD, Gregory A. Schmidt, MD, FCCP

    PII: S0012-3692(15)00048-3

    DOI: 10.1378/chest.15-1369

    Reference: CHEST 47

    To appear in:   CHEST 

    Received Date: 5 June 2015Revised Date: 15 September 2015

     Accepted Date: 16 September 2015

    Please cite this article as: Nassar BS, Schmidt GA, Capnography During Critical Illness,CHEST  (2015),

    doi: 10.1378/chest.15-1369.

    This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to

    our customers we are providing this early version of the manuscript. The manuscript will undergo

    copyediting, typesetting, and review of the resulting proof before it is published in its final form. Pleasenote that during the production process errors may be discovered which could affect the content, and all

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    http://dx.doi.org/10.1378/chest.15-1369

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    B S. N MD

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    A

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    , . T

    , ;

    ; . I ,

    . A

    , ,

    PCO2.

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    C (CO2)

    . B 1990

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    I III

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    ) .

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    , CO2  , ,

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    ), CO2 (PACO2)

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    PACO2  ( ) PCO2 , 7 H

    . I , ETCO2  PCO2 (

    ) , (

    VCO2; ; ).

    T ETCO2  PCO2 (F 3;

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    PCO2  CO2 

    ,

    (T 1). P III CO2  ,

    DB 70 .7 

    C III ,

    . T

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    IV, I, , .

    T CO2  3

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    F ,

    , . Y ETCO2 

    PCO2  , , T

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    1.9,10,11,12 ETCO2  PCO2  13. W

    , ETCO2  PCO2  ,

    14 (F 3). F, ETCO2

     

    PCO2.15,16 P ETCO2 

    . F , ETCO2 

    ( CO2 ) PCO2 ,

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    : , PEEP ARDS.17 18 19 20 T ETCO2  PCO2  .

    N, ,

    .21 I

    .

    P

    P (PE) ICU. W

    (CTA) ,

    , ,

    , CTA . PE

    , ,

    . B , PE ) ( ); ) CO2 

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    V/Q CO2); ) III ( COPD

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    V , , CO2 

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    .22 I , PE

    CO2 .23 T .24 

    25I ,

    .25 A

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    CO2  PCO2 

    . W 1215%, ,

    ETCO2  PCO2 , PE. 26 27 28 29 30 O

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    ETCO2:PCO2  D

    PE .25 

    D PCO2  ETCO2  PE.

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    III . I , PE III ( ,

    ) 31;

    .32 I

    PE, III PE.26 

    I 14 2291 , PE

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    . F, :

    . A PE , CO2 

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    , .

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    V/Q ( PACO2), .

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    . T ,

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    . A III

    (COPD, ) 36, 37. T

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    CT 42. A

    . C , ETCO2,

    , ETCO2, COPD

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    .43 C

    , ,

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    ETCO2  PCO2, ,

    .46,47 A , ,

    ETCO2  PCO246,

    . I COPD ETCO2  PCO2 

    40H,

    ETCO2 .

    C :

    I ETCO2  (ROSC)48,49, 50; (PLR) 51, 52, 53; 54, 55.

    T ETCO2. I

    , , CO2 

    , 56. C ETCO2 

    , .

    T ETCO2 

    CO2.55 57 58F ,

    , ETCO2  CO2  . A , PCO2 ,

    CO2  , . B CO2 

    CO2 , . I ,

    ( ,

    ).59 60 T

    .

    T ETCO2  F P.

    R CO2  ,

    ( ) ETCO2. T, , ( ) ETCO2 

    . A ETCO2  ,

    , .

    C (CPR): D CPR ,

    , .61 62 A ETCO2 

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    .66 P

    , CPR .

    CPR . S

    .67 W , ROSC

    ETCO2 ( 5).48, 49, 50 W

    ICU,

    .

    P : T

    68,69. S ,

    . PLR

    51

    , , . ETCO2 

    . I , ETCO2 

    5% PLR, . 51,

    52, 53 

    P :

    S ,

    , . M 70  , ,

    , . S

    , . W

    ETCO2, ;

    VQ ETCO2.71 O

    , ,

    . S

    , ,

    . 72,73,74,75,76 B 12

    ,

    , . 73, 77

    C

    C ICU,

    . Y

    CO2 

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    . A , ,

    PCO2.

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    T 1: D III ETCO2 

    A :VCO2

    M

    V/Q

    R CO2 

    V

    B

    L (PEEP)

    C

    D PCO2 ( F P)

    O

    S (

    , , ) 78 

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    F L

    F 1: T (1A) (1B).

    I, II, III IV ; SII= II; SIII=

    III; PACO2 = CO2; ETCO2= CO2; α= II III.

    F 2: A PCO2 

    T PACO2  . A , PACO2 

    CO2 

    . T, PACO2  , CO2,

    . D , CO2  . M 7.

    F 3: G PCO2  ETCO214

    T PCO2  ETCO2  .

    A , ,

    . M 14.

    F 4: T V/Q PACO2  , COPD, PE. T

    , , PCO2 

    (PCO2 = 40). I , A . T

    , V/Q , PACO2  (PCO2 = 47). W

    V/Q COPD, B

    , . S ,

    PACO2, , PCO2.

    F, ( )

    (PCO2 = 0) ,

    ( C). PACO2 = CO2;

    PCO2 = PCO2; PCO2 = PCO2.

    F 5:

    5: T ,

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    5: T . A

    , PCO2 ( ). ROSC

    PCO2 ( ).

    5: C :

    . C ,

    . T ,

    CO2 . T

    .

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    2009;24(5):283292.2 M NM, S CD, J KF, H JM, T R, D CP. A

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