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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
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http://dx.doi.org/10.1378/chest.15-1369
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B S. N MD
A
G A. S, MD, FCCP
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G A. S, MD
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C ICU,
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, . T
, ;
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, ,
PCO2.
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C (CO2)
. B 1990
. T
1;
, . Y
,
(V) (Q) ;
(COPD); (PE)
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(ROSC);
; ; 2.
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; CO2 (ETCO2) ;
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, . I , II
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I III
. F , II V Q ,
V/Q ( PCO2
) .
T II.
P III , PCO2 . I
, CO2 , ,
, . I (
), CO2 (PACO2)
CO2 (PCO2). B , , PACO2 ,
7,8 (F 2). T
PACO2 ( ) PCO2 , 7 H
. I , ETCO2 PCO2 (
) , (
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T ETCO2 PCO2 (F 3;
), .
A III , PCO2 ,
PCO2 CO2
,
(T 1). P III CO2 ,
DB 70 .7
C III ,
. T
III V/Q . F,
IV, I, , .
T CO2 3
( IV ; 1B). P I
. P II
, III . T
, III
.
C ETCO2 PCO2
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 ,
, ETCO2 PCO2 . B PEEP ,
: , PEEP ARDS.17 18 19 20 T ETCO2 PCO2 .
N, ,
.21 I
.
P
P (PE) ICU. W
(CTA) ,
, ,
, CTA . PE
, ,
. B , PE ) ( ); ) CO2
III PCO2 ETCO2 (
V/Q CO2); ) III ( COPD
V/Q ; F 4).
V , , CO2
( B
). I PE,
,
.22 I , PE
CO2 .23 T .24
25I ,
.25 A
ETCO2 ,
III 15% . T
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.
M V/Q ,
III . I , PE III ( ,
) 31;
.32 I
PE, III PE.26
I 14 2291 , PE
0.80 0.49.33 T PE
. F, :
. A PE , CO2
. M,
, ICU. F,
, .
N, ,
PE, D .
O L D:
O V/Q ,
(F 4).34 T II
V/Q ( PACO2), .
D III, V/Q (
V/Q PACO2 , V/Q
PACO2 ), . T
II III 35. I ,
(F 5). T III
. T ,
, PCO2 .
T
. A III
(COPD, ) 36, 37. T
36,37,38,39,40,41
CT 42. A
. C , ETCO2,
, ETCO2, COPD
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.43 C
, ,
.44,45
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
.
1 R P, E LA. C : . J I C M
2009;24(5):283292.2 M NM, S CD, J KF, H JM, T R, D CP. A
.
C N. 2015;34(1):15153 G JS, R PR, JL, S RN. C
. A A 1990;7019144 ML BA, H MB, G J, Y DM, M JJ. V
CO2 . A E M. 1991;20(3):26770.5 SS F, B SH, T G. V : . C O C C 2014;
20:333339.6 L C, L KC, K HY,.. U
. K J A 2013; 65(4):33740.7 DB AB, B AG, F WO. A CO2 . J A P 1952; 4:53548.
8 H MP. A . R P 1972;
15:214232.9 K M, G E, E O, . T ETCO 2 COPD
. E J E M. 2011;8(1):91210
D S, F Y, R R, . C
ED. A J E M 2010;28:7114.11
P G, H H, L P, P H, SJ F, S J. A CO2
CO2 . R. 1997;35:145 148.12 L SW, H YS, H C, . C
. J T 2009; 67:526530.13
Y MK, S DY. C PCO2 /
. C 1987; 92(5):832835.14
H DR, S A, L B, . A PCO2
. R C 1991; 36:837843.15
R GB, G JM. T
. A A 1995;81(4):806810.16
W KJ, C J, G B, . T
. J T. 2009;66:26 31
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17
T G, SS F, B SH, B JB, H G. C /
. A A S 2011;55:59760618
T G, SS F, B SH, P T, R H, M G. M PEEP . I C M 2006;32:18637119
M S, R H, F B, C
. A A 2008;106:1758120
F G, J C, S L, C Y, Y Y. D
. R C
2012;57(10):157885.21
N J, K B. C: . E M C N A 2008;26: 881
89722
C C, F P, M J, . U
. C C M 1990 ;18(4):3537.23
R ED, J DG, T DM, C CH.A
. N E J M. 1959 ;260(12):58691.24
K JA, I EG, M EA, . D D
. A . JAMA 2001;285:761768.25
K JA, M S, B D, . U (V/V) D
. A E M 1997; 4:85686326
V F, L G, C R, . V
. C. 2004;125(3):84150.27
R MA, J G, R P, . S D:
. C. 2001 ;120(1):1159.28
E L, W P, O CG, . D
. C.1989;96:357362.29
O K, J B, O CG, W P. D
. J I M. 1998;244(3):199207.30
A JT, O JT, G JE. B . A S 1999; 134:869 87431
S MS, L LG, G SR, H EA, S PW, N GR. M III
CO2 III SF6. R P. 1993;91(23):13754.32
M MM, T RG, C CH, O N AF, P MC, P IA. A
. V H R
M. 2009;5(1):91233
M A, D' W, T F.C : . A
E M. 2013;62(6):5849134
H BI.T : . T.
1966;21(6):51823.35
S NO, G PM.V
. P P. 2000 ;29(2):94
102.36
V L, M MM, S ST, P MC, R MA, R JD.V
. L
2010; 188(3):263268.37
K AH, B JM, S T, V J, V AF, H C. D
. E R J 1997;10(8):1829183638
Q GS, G WC, Y WL, X F, W H, L JM.T A V C D
C O P D P N S. L. 2014 ;192(5):661839
Y B, P R, D C, V VD, G JP. E . E R J. 1994 ;7(2):31823.40
R PV, R B, O D, B L, M F.V
. I J C O P D. 2007;2(3):38191.
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41
N H NAR, R A, C KS, K J, I , T AH. C
. I J E
M 2009; 2:8389.42
B RH, B A, W RA, .F
(COPD). J B R. 2013;7(1):01710843
M RJ, V GC, D K, . A COPD
COPDCHF . IEEE T B E. 2014;61(12):28829044
V S, S D, M M, P M, V W. N
: . A J R C C M. 2004;170(4):41441945
C M, G H, H JC, . T
. N E J M. 1978;298(23):12771281.46
L M, C E, M A, A M, V L, D C. C :
. M S M. 2008
;14(9):CR48592.47
K M, G E, E O, . T ETCO2 COPD
. E J E M 2011;18:912.48
F JL, R EC, W MH.E . N
E J M. 1988;318(10):60711.49 P M, N E, K J, S R, A M, F O. A
(P(ET)CO(2)) . J E M. 2010 ;38(5):6142150
S DJ, R CE.M
. A E M. 1990 ;7(3):12934.51
M X, B A, M E, .E
. I C M. 2013 ;39(1):9310052
Y A, M PE, S S, G D, L A.C ET C D V C
D P V R H U P. J C V
A. 2013 ;27(4):6814
53M G MI, G C A, G R M, M P R, P M V, D M JC.N CO2
. A I C. 2012 26;2:954
D A, M G, E E, .E CO2 . I
C M. 2000 ;26(11):161923.55
J X, W MH, T W, .E
. C C M. 2000 ;28(7):24159.56
A CT, B PH. C . C C 2000; 4:207215.57
S K, M M, S S, K K, S VT, G P.D PCO2
? A A. 1994 ;79(5):82933.58
M A, S G, B A, .M
. A A. 2001 ;92(2):30613.59
I SA, B PH. C PCO2 ? A A. 1991
;73(6):80814.60
O JP, G AR, G FL. R
. A E M. 1990;19(10):11046.61
G C V, W M H, B J, D H G, R E C. E :
. C. 1988;77:23423962
W MH, B J, T RP, R EC. C . C C M. 1985
;13(11):9079.63
L RL, W MA, M CC. E . N E J
M. 1997 ;337(5):3016.64
K M, K M, K P, G S. P
: . C C. 2008;12(5):R115
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65
S AB, A M, E GA, K KB, B S.E PCO2 . A J
E M. 1985 ;3(2):1479.66
H BE, S K, S GA, WL T, H JK. F 575 .
R. 2012 ;83(7):8138.67
P NA, M GB, R EP, . C
. JAMA. 1990 ;263(8):110613.68
D L, S GA. F : . C. 2008 ;133(1):2526369
L MR, A B, B GT, , .. R . C
2015; doi:10.1378/chest.15-0445 ( ).70
P S, V JJ, K F, . D
. A J G. 2005;100:2689269571
K B, H DR. C . A
E M. 2007 ;50(2):1728172
V JJ, G J, D JA, . A
. G E. 2002;55: 826831.73
D K, M J, C CR, . D CO2
? , . A
E M 2010; 55:258266.74
W JB , E CA , K YA . C
: . J C A 2011 ; 23 : 189 9675
C G, PC JL, B A, L JL, O R, FR CM. C
. R E E D. 2010 ;102(2):869.76
S C, W A, W S, K EF, S RM, D S. C C
. C J G. 2013;27(10):5826.77
B A, R A, M A, . C : , (CC
S). A J G 2012;107:12051278
S JD, G SR, N GR, A SJ, S PW. S CO2
. A B E. 1991;19(6):67997.
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