Capnography, VENTILATION
Conditions
Keywords
Capnometry, Capnography, ETCO2, Recovery room, Post-anesthesia care unit
Brief summary
There is few information about the best capnometry value in recovery room for intubated awakening patients. Furthermore, capnometry values could influence ventilation applied by nurses on these patients. The aim of this study is to observe the effects of capnometry monitoring on intubated awakening patients in recovery room.
Detailed description
In France, there is actually no recommandation about capnography monitoring in recovery rooms. Nevertheless, some patients are still ventilated in post-anesthesia care units during awakening period. Alveolar hypoventilation could induce moderate hypercapnia, thereby stimulate central ventilatory command. However, this hypoventilation could delay the clearance of anesthetic gases. Capnometry monitoring could influence ventilation applied to these patients. Recovery rooms nurses would perform moderate hyperventilation in response to hign capnometry values. This method could enhance gases elimination, with faster spontaneous breathing recovery and extubation. Length of stay in recovery room could also be shortened. An objective surrogate of ventilation is maximal End Tidal CO2, if there is no alveolo-capillary gradient abnormality (Obesity, Chronic respiratory disease, Cyanogenic heart disease). Thus, this study will compare the percentage of patients who reached a maximum End Tidal CO2 greater than 45mmHg during awakening period in post-anesthesia care unit (PACU) in 2 groups : * first group (non-blind group) with capnography monitoring see by the PACU nurses * second group (blind group) with capnography monitoring but PACU nurses cannot see the values Other parameters like the time between ventilator's disconnection and the first ventilatory cycle in spontaneous ventilation, the time between ventilator's disconnection and tracheal extubation or laryngeal mask's withdrawal, the minimal SpO2 reached after tracheal extubation or laryngeal mask withdrawal or the length of stay in PACU are also recorded.
Interventions
DEVICECAPNOGRAPHY
MONITORING OF CAPNOMETRY USING ETCO2 METHOD
Sponsors
University Hospital, Bordeaux
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Major patients with given written consent * General anesthesia, induction with Propofol infusion and Target-Controlled Infusion (TCI) remifentanil, relayed with inhaled sevoflurane and TCI remifentanil * Upper airway control with naso-orotracheal tube or laryngeal mask * Ventilated normotherm patients in PACU
Exclusion criteria
* Minor or pregnant patients * Obesity with Body Mass Index \> 40 kg/m² * Chronic respiratory disease with SpO2\<90% in ambiant air * Cyanogenic heart disease * Patients under myorelaxant in PACU
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| End Tidal CO2 up | through awakening period in PACU, an average of 30 minutes | Percentage of patients who reached a maximum End Tidal CO2 greater than 45mmHg during awakening period in post-anesthesia care unit (PACU) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| End Tidal CO2 max 2 | through awakening period in PACU, an average of 30 minutes | Maximum EtCO2 reached after the first ventilatory cycle in spontaneous ventilation |
| respiratory rate | through awakening period in PACU, an average of 15 minutes | Respiratory rate applied by PACU nurse before the first ventilatory cycle in spontaneous ventilation |
| spontaneous ventilation time | through awakening period in PACU, an average of 15 minutes | Time (in minutes) between ventilator's disconnection and the first ventilatory cycle in spontaneous ventilation |
| End Tidal CO2 max 1 | through awakening period in PACU, an average of 15 minutes | Maximum EtCO2 reached before the first ventilatory cycle in spontaneaous ventilation |
| Spo2 min | through awakening period in PACU, an average of 2 hours | Minimal SpO2 after tracheal extubation or laryngeal mask withdrawal |
| length of stay in PACU | through awakening period in PACU, an average of 2 hours | Length of stay in PACU in minutes |
| time for oxygenotherapy removal | through awakening period in PACU, an average of 1 hour | Time (in minutes) between tracheal extubation or laryngeal mask withdrawal and oxygenotherapy weaning |
| time for removal of airway device | through awakening period in PACU, an average of 30 minutes | Time (in minutes) between ventilator's disconnection and tracheal extubation or laryngeal mask's withdrawal |
Countries
France
Outcome results
None listed