Monitoring of the carbon dioxide exhaled during the non invasive ventilation in patients with acute chronic obstructive lung disease

Authors

Keywords:

, non-invasive ventilation, capnography, chronic obstructive lung disease.

Abstract

Introduction: The monitoring of the carbon dioxide exhaled is frequently used in the intensive cares units, but its use in non invasive ventilation is scarce.  

Objective: To identify the association between the blood pressure of carbon dioxide and the carbon dioxide exhaled, during non invasive ventilation, in patients with acute chronic obstructive lung disease.  

Methods:  An observational, descriptive, longitudinal and prospective study of 126 patients admitted with acute chronic obstructive lung disease was carried out, they were treated with non invasive ventilation, in the Intensive Cares Unit of Saturnino Lora Torres Teaching Provincial Clinical-Surgical Hospital in Santiago de Cuba, from January, 2019 to the same month in 2022, selected by intentional non probabilistic sampling. Clinical, ventilatory and hemogasometric variables were analyzed, of which the minimum and maximum values were identified, as well as the mean, standard and medium deviation.  The Pearson correlation coefficient was applied. 

Results: The average values of carbon dioxide exhaled were 57.83 ± 8.9 and those of arterial pressure of carbon dioxide, 59.85± 9.3. When analyzing the correlation among the variables, positive correlation was observed among both, for a Pearson correlation coefficient of 0.920.  

Conclusions: The monitoring of carbon dioxide exhaled acts as a variable to consider in the monitoring of patients with acute chronic obstructive lung disease, treated with non invasive ventilation, whenever the appropriate face mask is used and the leaks are controlled, with strong correlation with the arterial pressure of the carbon dioxide.   

Downloads

Download data is not yet available.

References

1. Yao JJ, Meng PM, Zou G H, He KX, Ma DD. Effects of flow on carbon dioxide washout and nasal airway pressure in healthy adult volunteers during the constant-flow mode in a non-invasive ventilator. Chin Med J. 2020 [citado 09/03/2022];133(20):2515-17. Disponible en: https://medcentral.net/doi/epdf/10.1097/CM9.0000000000001079

2. Díaz Cedeño HI, Monroy Pesantez MF, Macías Ponce D I, Tuarez Villegas IL. Utilidad de la capnografía en urgencias. RECIMUNDO. 2019 [citado 15/03/2022];3(3): 218-38. Disponible en: https://recimundo.com/index.php/es/article/view/598

3. Borsini E, Codinardo C, Rabec C. Monitoreo de la ventilación no invasiva. RAMR 2021 [citado 15/03/2022];1:83-93 Disponible en: http://www.ramr.org/articulos/volumen_21_numero_1/suplemento_guias/capitulo_10.pdf

4. Benites Albanese MH, Poblete Barrera F, Céspedes Valenzuela RC, Gil D, Riquelme C, Olive F, et al. Capnografía volumétrica y su aplicación en la monitorización de la ventilación mecánica. Rev Chil Med Intens. 2019 [citado 15/03/2022]; 34(3):1-10. Disponible en: https://www.medicina-intensiva.cl/revista/pdf/2.pdf

5. Núñez García V. Caracterización del aporte de las compresiones torácicas al valor de CO2 espirado final durante la reanimación cardiopulmonar. [Tesis Maestría] Universidad del País Vasco, 2021 [citado 15/03/2022]. Disponible en: https://addi.ehu.es/handle/10810/52712?show=full

6. Caro Alonso PA, Rodríguez Martín B. El dióxido de carbono al final de la espiración como signo precoz y valor pronóstico de la recuperación de la circulación espontánea en la parada cardiaca extrahospitalaria. Una revisión sistemática. Rev. Esp. Salud Pública. 2021 [citado 15/03/2022];95(1). Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1135-57272021000100186

7. Rabec CA, Reybet Degata O, Bonniaud P, Fanton A, Camus P. Monitorización de las fugas en ventilación no invasiva. Arch Bronconeumol. 2004 [citado 09/03/2022];40(11):508-17. Disponible en: https://www.archbronconeumol.org/es-monitorizacion-fugas-ventilacion-no-invasiva-articulo-resumen-S0300289604755829

8. Bernabe Vera L. ¿Cuál es la relación entre el volumen tidal espiratorio medio y la tasa de aclaramiento de pCO2 en los pacientes sometidos a ventilación mecánica no invasiva? [Tesis Doctoral]. Murcia: Universidad Miguel Hernández; 2017 [citado 20/02/2022]. Disponible en: http://dspace.umh.es/jspui/bitstream/11000/4344/1/BERNABE%20VERA%2c%20LORENA%20.pdf

9. Sánchez Vallejo A. Aproximación a la ventilación mecánica. Monitorización de la asistencia ventilatoria. Tiempos de Enfermedad y Salud. 2019 [citado 20/02/2022]; 1(5). Disponible en: https://tiemposdeenfermeriaysalud.es/journal/article/view/20

10. Ergan B, Oczkowski S, Rochwerg B, Carlucc A, Chatwin M, Clini, E, et al. European Respiratory Society guidelines on long-term home non-invasive ventilation for management of COPD. Eur Respir J. 2019 [citado 09/03/2022]; 54. Disponible en: https://erj.ersjournals.com/content/erj/54/3/1901003.full.pdf

11. Nuccio P, Hochstetler G, Jackson M. End-tidal CO 2 measurements with noninvasive ventilation. In: Abstracts presented at the International Symposium “Innovations and applications of monitoring oxygenation and ventilation” (ISIAMOV), Duke University, Durham, NC, March 15–17, 2007. Anesth Analg. 2007 [citado 09/03/2022];105(6):111-5. Disponible en: https://journals.lww.com/anesthesia-analgesia/Citation/2007/12001/Abstracts_Presented_at_the_International_Symposium.16.aspx

12. Sakuraya M, Douno E, Iwata W, Takaba A, Hadama K, Kawamura N. Accuracy evaluation of mainstream and sidestream end-tidal carbon dioxide monitoring during noninvasive ventilation: a randomized crossover trial (MASCAT-NIV trial). J Intensive Care. 2022 [citado 09/03/2022];10(1):17. Disponible en: https://jintensivecare.biomedcentral.com/track/pdf/10.1186/s40560-022-00603-w.pdf

13. Esquinas AM. Noninvasive Mechanical Ventilation: Theory, Equipment, and Clinical Applications. 2 ed. Switzerland: Springer International Publishing; 2016 [citado 06/04/2022].p.851. Disponible en: https://link.springer.com/book/10.1007/978-3-319-21653-9

14. Enfermedad Pulmonar Obstructiva Crónica (EPOC) GOLD 2020, GESEPOC 2021; 2021 [citado 04/03/2022]. Disponible en: https://1aria.com/images/entry-pdfs/epoc-2021-gold-2020-gesepoc-2021.pdf

15. Schwarz SB, Windisch W, Magnet FS, Schmoor C, Karagiannidis Ch, Callegari J, et al. Continuous non-invasive PCO2 monitoring in weaning patients: transcutaneous is advantageous over end-tidal PCO2. Respirology. 2017 [citado 09/03/2022]; 22(8): 1579-84. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28613389/

16. Van der Leest, S, Duiverman ML. High-intensity non-invasive ventilation in stable hypercapnic COPD: Evidence of efficacy and practical advice. Respirology. 2019 [citado 09/03/2022];24:318–28. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/resp.13450

17. Baba Y, Takatori F, Masayuki Inoue M, Matsubara I. A Novel Mainstream Capnometer System for Non-invasive Positive Pressure Ventilation. Annu Int Conf IEEE Eng Med Biol Soc. 2020 [citado 09/03/2022];2020: 4446-9. Disponible en: https://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=9175950

18. Borel JCh, Palot A, Patout M. Technological advances in home non-invasive ventilation monitoring: Reliability of data and effect on patient outcomes. Respirology, 2019 [citado 09/03/2022]; 24(12), 1143–51. Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/resp.13497

19. Radogna AV, Siciliano PA, Sabina S, Sabato E, Capone S. A low-cost breath analyzer module in domiciliary non-invasive mechanical ventilation for remote COPD patient monitoring. Sensors. 2020. [citado 09/03/2022]; 20(3), 653. Disponible en: https://www.mdpi.com/1424-8220/20/3/653

20. Aarrestad S. Monitoring long-term nocturnal non-invasive ventilation for chronic hypercapnic respiratory failure: What are the basic tools? 2020. [Tesis. University of Oslo]. [citado 09/03/2022] Disponible en: https://www.duo.uio.no/handle/10852/74185

Published

2022-10-03

How to Cite

1.
Navarro Rodríguez Z, González Aguilera JC, Romero García LI. Monitoring of the carbon dioxide exhaled during the non invasive ventilation in patients with acute chronic obstructive lung disease. MEDISAN [Internet]. 2022 Oct. 3 [cited 2025 Jun. 4];26(5):e4321. Available from: https://medisan.sld.cu/index.php/san/article/view/4321

Issue

Section

Original Articles