\ What does a sloped upstroke on a capnogram indicate? - Dish De

What does a sloped upstroke on a capnogram indicate?

This is a question our experts keep getting from time to time. Now, we have got the complete detailed explanation and answer for everyone, who is interested!

Prolongation or slanting of the expiratory upstroke phase II occurs when there is obstruction to expiratory gas flow (e.g., asthma, bronchospasm, obstructive pulmonary disease, and kinked endotracheal tube,19 or in the presence of leaks in the breathing system.

What does a flat plateau on a Capnogram indicate?

The waveform reflects an elevation of baseline, as well as the plateau, indicating incomplete exhalation. The CO2 is not being appropriately removed. This is often due to insufficient expiratory time, inadequate inspiratory flow, or faulty expiratory valve.

What is respiratory upstroke?


Phase I (inspiratory baseline) reflects inspired gas, which is normally devoid of carbon dioxide. Phase II (expiratory upstroke) is the transition between VDana, which does not participate in gas exchange, and alveolar gas from the respiratory bronchioles and alveoli.

What characteristics are observed in a normal Capnogram?

A normal capnogram for patients of all ages is characterized by a set of specific elements: it includes 4 distinct phases (Figure 1), the CO2 concentration starts at zero and returns to zero (ie, there is no rebreathing of CO2), a maximum CO2 concentration is reached with each breath (ie, ETCO2), the amplitude depends …

What does the Y axis represent on a Capnogram?

Understanding the Capnography Waveform

A capnogram plots CO2 concentration over time and consists of four phases. The x-axis measures time, and the y-axis shows the concentration of CO2. The first phase of the capnogram starts exhalation.

Capnography Waveform Interpretation (Etco2 basic’s explained)

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What is normal ETCO2?

End-tidal CO2 (EtCO2) monitoring is a noninvasive technique which measures the partial pressure or maximal concentration of carbon dioxide (CO2) at the end of an exhaled breath, which is expressed as a percentage of CO2 or mmHg. The normal values are 5% to 6% CO2, which is equivalent to 35-45 mmHg.

What is ETCO2 detector?

[1] On the most basic level, end-tidal CO2 (ETCO2) detectors are used to measure the exhaled concentration of carbon dioxide. The concentration of exhaled CO2 correlates to the arterial concentration of CO2, although multiple factors can impact the relationship.

What ETCO2 confirms adequate ventilation?

Teams should aim for EtCO2 at least >10 mm Hg and ideally >20 mm Hg. Where do these numbers come from? These values are approximately 1/4 the normal EtCO2 (35-45 mm Hg), and ideal CPR will provide at least 1/4 of cardiac output. This is an example of capnography during CPR.

What increases ETCO2?

In severe cases of respiratory distress, increased effort to breathe does not effectively eliminate CO2. This causes CO2 to accumulate in the lungs and more of it to be excreted with each breath (hypercapnea), which would cause the ETCO2 level to rise.

What happens when a patient Hypoventilates?

Hypoventilation is breathing that is too shallow or too slow to meet the needs of the body. If a person hypoventilates, the body’s carbon dioxide level rises. This causes a buildup of acid and too little oxygen in the blood.

What is the primary gas expelled from the respiratory system during exhalation?

At the same time, carbon dioxide, a waste gas, moves from your blood to the lungs and is exhaled (breathe out). This process is called gas exchange and is essential to life.

What is the definition of respiratory failure?

Respiratory failure is a condition in which your blood doesn’t have enough oxygen or has too much carbon dioxide. Sometimes you can have both problems. When you breathe, your lungs take in oxygen. The oxygen passes into your blood, which carries it to your organs.

What affects rate and depth of breathing?

Factors Influencing Breathing

CO2 levels are the main influence, oxygen levels only affect breathing with dangerously low. If CO2 levels increase, the respiratory center( medulla and pons) is stimulated to increase the rate and depth of breathing.

Is low ETCO2 acidosis?

In hypoperfused patients with metabolic acidosis from shock states, EtCO2 decreases because of a compensatory increase in minute volume resulting from a decrease in serum bicarbonate (HCO3). [11] The more acidotic the patient becomes, the lower the serum HCO3, the greater the respiratory rate, and the lower the EtCO2.

What causes decreased ETCO2?

Low ETCO2 with other signs of shock indicates poor systemic perfusion, which can be caused by hypovolemia, sepsis or dysrhythmias. Cardiac arrest is the ultimate shock state; there is no circulation or metabolism and no CO2 production unless effective chest compressions are performed.

What does curare cleft indicate?

Curare Cleft:

A dip in the plateau (curare cleft) indicates a spontaneous respiratory effort during mechanical ventilation.

What is the treatment for hypercapnia?

If you get hypercapnia but it isn’t too severe, your doctor may treat it by asking you to wear a mask that blows air into your lungs. You might need to go the hospital to get this treatment, but your doctor may let you do it at home with the same type of device that’s used for sleep apnea, a CPAP or BiPAP machine.

What is ETCO2 used for?

End-tidal carbon dioxide (ETco2) monitoring provides valuable information about CO2 production and clearance (ventilation). Also called capnometry or capnography, this noninvasive technique provides a breath-by-breath analysis and a continuous recording of ventilatory status.

What is ETCO2 a good indicator of?


ETCO2 concentration is a reliable index of effective heart compression during CPR, which is associated with cardiac output (7, 8).

Why is ETCO2 low during CPR?

Low ETCO2 (below 10 mm HG) may be caused by either poor compression technique, or from low perfusion and metabolism after a long downtime or shock despite good compressions.

What is the effect of excessive ventilation?

What happens with excessive breathing is that it increases intrathoracic pressure, which reduces coronary perfusion because blood can’t flow back into the heart. “It reduces venous blood return to the heart, and reduced blood return means reduced blood outflow from the heart,” says Aufderheide.

How do you measure exhaled CO2?

The amount of carbon dioxide exhaled at the end of each breath (EtCO2) is measured through a sensor located between the patient’s airway and ventilator and is then numerically and graphically displayed as a waveform. Capnography: It’s a Gas!

What color does the CO2 detector change?

A nontoxic chemical indicator quick- ly responds to exhaled CO2 with a simple color change from purple to yellow.

What is the possible cause for the absence of CO2 waveform immediately after intubation?

When CO2 is absent as measured by end-tidal capnography, it means either the endotracheal tube is in the wrong position (esophageal) or there is an absent or decreased presentation of CO2 to the lungs. Capnography can be used to confirm successful endotracheal intubation.