The Use of Catheter Mount Will Result in More Reliable Carbon Dioxide Monitoring under Fluid Exposing Conditions

Yongil Cho; Wonhee Kim; Tae Ho Lim; Hyuk Joong Choi; Jaehoon Oh; Bossng Kang; Youjin Kim; In Young Kim

doi:10.1155/2019/4120127

The Use of Catheter Mount Will Result in More Reliable Carbon Dioxide Monitoring under Fluid Exposing Conditions

Emerg Med Int. 2019 Jul 1:2019:4120127. doi: 10.1155/2019/4120127. eCollection 2019.

Authors

Yongil Cho¹, Wonhee Kim^{2

3}, Tae Ho Lim¹, Hyuk Joong Choi¹, Jaehoon Oh¹, Bossng Kang¹, Youjin Kim⁴, In Young Kim³

Affiliations

¹ Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
² Department of Emergency Medicine, College of Medicine, Hallym University, Seoul, Republic of Korea.
³ Department of Biomedical Engineering, College of Medicine, Hanyang University, Seoul, Republic of Korea.
⁴ Department of Plant Biology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA.

Abstract

Introduction: Capnometer can be readily malfunctioned by fluid exposure during treatment of critically ill patients. This study aimed to determine whether placing capnometer distant from the endotracheal tube by connecting direct connect catheter mount (DCCM) is effective in yielding reliable end-tidal carbon dioxide (ETCO₂) by reducing capnometer malfunctioning caused by water exposure.

Methods: In 25 healthy adults, a prospective, open label, crossover study was conducted to examine the effect of DCCM in mainstream and microstream capnometers under water exposing conditions. The primary endpoint was the comparison of ETCO₂ between proximal DCCM (pDCCM) and distal DCCM (dDCCM).

Results: For mainstream capnometers, mean ETCO₂ was significantly (p < 0.001) higher in dDCCM compared to pDCCM under water exposing conditions (29.5 vs. 19.0 with 5 ml; 33.8 vs. 21.2 with 10 ml; mmHg). Likewise, for microstream capnometers, ETCO₂ was greatly higher (p < 0.001) in dDCCM compared to pDCCM (30.5 vs. 13.9 with 5 ml; 29.9 vs.11.4 with 10 mL; mmHg). ETCO₂ measured by dDCCM was reliable in microstream settings, whereas it was unreliable in mainstream (correlation coefficient 0.88 vs. 0.27).

Conclusions: Application of DCCM onto the capnometer setting seems to be effective in reducing capnometer malfunctioning under fluid exposing conditions, which is obvious in microstream capnometer by producing more reliable ETCO₂.