EBQ:End-Tidal CO2 Monitoring - Revision history

Danbot: Mark as Complete - article has all required sections

2026-03-21T22:11:24Z

Mark as Complete - article has all required sections

← Older revision		Revision as of 22:11, 21 March 2026
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			\| status = Complete
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	==Clinical Question==		==Clinical Question==

2025-05-21T19:59:24Z

Funding

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	==Funding==		==Funding==
	Medtronic Emergency Response Systems loaned the LIFEPAK 12 monitors for the study		*Medtronic Emergency Response Systems loaned the LIFEPAK 12 monitors for the study

	==References==		==References==

2025-05-21T19:59:03Z

Major Points

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	==Major Points==		==Major Points==
	33% of PSA encounters included acute respiratory events.		*33% of PSA encounters included acute respiratory events.
			*85% of those with respiratory events had abnormal ETCO₂ findings.
	85% of those with respiratory events had abnormal ETCO₂ findings.		*In 70% of events, abnormal ETCO₂ was recorded before observed clinical signs.
			*Many ETCO₂ abnormalities were not associated with interventions, suggesting possible transient or clinically insignificant episodes.
	In 70% of events, abnormal ETCO₂ was recorded before observed clinical signs.		*Use of capnography may enhance detection of early hypoventilation or apnea and improve patient safety during PSA.

	Many ETCO₂ abnormalities were not associated with interventions, suggesting possible transient or clinically insignificant episodes.

	Use of capnography may enhance detection of early hypoventilation or apnea and improve patient safety during PSA.

	==Study Design==		==Study Design==

2025-05-04T03:26:30Z

Funding

← Older revision		Revision as of 03:26, 4 May 2025
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	==Funding==		==Funding==
			Medtronic Emergency Response Systems loaned the LIFEPAK 12 monitors for the study

	==References==		==References==

2025-05-04T03:26:05Z

Criticisms & Further Discussion

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	==Criticisms & Further Discussion==		==Criticisms & Further Discussion==
			* No continuous waveform data recorded; data points logged every 30 seconds
			* Sampling bias possible: higher than expected rate of respiratory events (33% vs. anticipated 15%)—may reflect sicker patients or deeper sedation
			* Some abnormal ETCO₂ findings were transient and not clinically significant
			* Study terminated early for ethical and safety reasons—planned for 250 patients but stopped after 60

	==Funding==		==Funding==

2025-05-04T03:25:32Z

Outcomes

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	===Primary Outcome===		===Primary Outcome===
			Detection of acute respiratory events, including:
			* SpO₂ < 92%
			* Increased oxygen requirements
			* Use of airway adjuncts or bag-valve mask
			* Patient repositioning
			* Physical/verbal stimulation
			* Reversal agent administration

	===Secondary Outcomes===		===Secondary Outcomes===
			Abnormal ETCO₂ defined as:
			* Change of ≥10 mmHg from baseline
			* Absolute value <30 mmHg or >50 mmHg

	===Subgroup analysis===		===Subgroup analysis===
			Of the 20 respiratory events:
			* 17 (85%) had abnormal ETCO₂ findings
			* 14 (70%) showed ETCO₂ abnormalities before SpO₂ or clinical observation changes
			* In 44% of cases with abnormal ETCO₂, no other clinical interventions were performed

	==Criticisms & Further Discussion==		==Criticisms & Further Discussion==

2025-05-04T03:23:56Z

Interventions

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	* No investigator available for enrollment		* No investigator available for enrollment

	==Interventions==		==Interventions==
			* Standard PSA monitoring: SpO₂, heart rate, respiratory rate, cardiac rhythm, and BP.
			* Study intervention: Continuous ETCO₂ monitoring via nasal cannula with integrated CO₂ sampling and oxygen delivery (2 L/min).
			* Clinical team blinded to ETCO₂ data.

	==Outcomes==		==Outcomes==

2025-05-04T03:23:28Z

Population

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	==Population==		==Population==
			* 59 patients undergoing 60 PSA encounters (1 patient had 2 separate sedations during the same ED visit).
			* Procedures included joint dislocations, cardioversions, wound closures, and fracture reductions.

	===Patient Demographics===		===Patient Demographics===
			* Median age: 38 years (range: 1–89)
			* 58% male
			* Most common PSA medication: Propofol (68%)

	===Inclusion Criteria===		===Inclusion Criteria===
			* Adults and children receiving PSA in the ED

	===Exclusion Criteria===		===Exclusion Criteria===
			* Inability to provide informed consent
			* No investigator available for enrollment

	==Interventions==		==Interventions==

2025-05-04T03:22:08Z

Study Design

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	==Study Design==		==Study Design==
	Prospective, observational case series using a convenience sample.		* Prospective, observational case series using a convenience sample.
			* Single-center, 500-bed tertiary hospital emergency department.
	Single-center, 500-bed tertiary hospital emergency department.		* Blinded design: Clinical staff were blinded to ETCO₂ readings; a study investigator monitored and recorded data.
			* Institutional review board-approved with interim safety analyses performed after every 30 patients.
	Blinded design: Clinical staff were blinded to ETCO₂ readings; a study investigator monitored and recorded data.

	Institutional review board-approved with interim safety analyses performed after every 30 patients.

	==Population==		==Population==

2025-05-04T03:21:30Z

Study Design

← Older revision		Revision as of 03:21, 4 May 2025
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	==Study Design==		==Study Design==
			Prospective, observational case series using a convenience sample.

			Single-center, 500-bed tertiary hospital emergency department.

			Blinded design: Clinical staff were blinded to ETCO₂ readings; a study investigator monitored and recorded data.

			Institutional review board-approved with interim safety analyses performed after every 30 patients.

	==Population==		==Population==
	===Patient Demographics===		===Patient Demographics===