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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
53
MONITORING OF CAPNOMETRY USING ETCO2 METHOD
Centre hospitalier Universitaire de Bordeaux
Bordeaux, France
End Tidal CO2 up
Percentage of patients who reached a maximum End Tidal CO2 greater than 45mmHg during awakening period in post-anesthesia care unit (PACU)
Time frame: through awakening period in PACU, an average of 30 minutes
End Tidal CO2 max 1
Maximum EtCO2 reached before the first ventilatory cycle in spontaneaous ventilation
Time frame: through awakening period in PACU, an average of 15 minutes
End Tidal CO2 max 2
Maximum EtCO2 reached after the first ventilatory cycle in spontaneous ventilation
Time frame: through awakening period in PACU, an average of 30 minutes
respiratory rate
Respiratory rate applied by PACU nurse before the first ventilatory cycle in spontaneous ventilation
Time frame: through awakening period in PACU, an average of 15 minutes
spontaneous ventilation time
Time (in minutes) between ventilator's disconnection and the first ventilatory cycle in spontaneous ventilation
Time frame: through awakening period in PACU, an average of 15 minutes
time for removal of airway device
Time (in minutes) between ventilator's disconnection and tracheal extubation or laryngeal mask's withdrawal
Time frame: through awakening period in PACU, an average of 30 minutes
Spo2 min
Minimal SpO2 after tracheal extubation or laryngeal mask withdrawal
Time frame: through awakening period in PACU, an average of 2 hours
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length of stay in PACU
Length of stay in PACU in minutes
Time frame: through awakening period in PACU, an average of 2 hours
time for oxygenotherapy removal
Time (in minutes) between tracheal extubation or laryngeal mask withdrawal and oxygenotherapy weaning
Time frame: through awakening period in PACU, an average of 1 hour