End-tidal kuldioxid monitorering af den ikke-intuberede, akutte patient giver potentiel diagnostisk og patientsikkerhedsmæssig værdi: End-tidal carbon dioxide monitoring of the non-intubated emergency patient provides a potential diagnostic and patient safety benefit - Betzer, Martin; Lyngby, Rasmus (Dansk Tidsskrift for Akutmedicin, 2022)
Baggrund End-tidal carbondioxid (etCO2) monitorering anvendes rutinemæssigt hos alle intuberede patienter. Kapnografi er ligeledes tilgængelig til den ikke-intuberede, akutte patient, hvor brugen i diagnostisk og patientsikkerhedsmæssigt øjemed er sparsomt beskrevet. Formål Formålet med denne statusartikel er at beskrive og diskutere eventuelle diagnostiske og patientsikkerhedsmæssige fordele og ulemper ved kapnografimonitorering af ikke-intuberede, akutte patienter. Metode Artiklen er baseret på resultatet af en systematisk litteratursøgning, hvor tilgængelig evidens fra 1990-2016 blev identificeret fra databaserne MEDLINE, Cinahl, Scopus, Cochrane og Academic Search Complete. Litteratur relevant for denne artikels emne blev udvalgt og gennemgået. Resultat Artiklen beskriver og diskuterer den udvalgte litteratur. Overordnet vidner denne om en diagnostisk og patientsikkerhedsmæssig fordel ved kapnografi til patienter med vejrtrækningsbesvær, til vurdering af effekt af medicinsk behandling samt til kontinuerlig monitorering. Artiklen diskuterer ligeledes anvendelsen af kapnografi præhospitalt og potentialet for brugen i Akutafdelingen. Konklusion Kapnografi findes i varierende grad at have potentiale indenfor diagnostik og kontinuerlig monitorering af akutte patienter, efter adækvat uddannelse i brugen. _________________________________________________________________________________________________________________________________ Background End-tidal carbon dioxide (etCO2) monitoring is routinely used in intubated patients. Capnography is also available for the non-intubated patient but its use as a diagnostic and patient safety tool is sparsely described. Aim The aim of this article was to describe and discuss potential diagnostic and patient safety benefits of capnography monitoring in acute, non-intubated patients. Methods The article is based on the results of a systematic literature search, where available evidence from 1990-2016 was located from the databases MEDLINE, Cinahl, Scopus, Cochrane and Academic Search Complete. Literature relevant for this article was selected and reviewed. Results The article describes and discusses the selected literature. Overall, there is evidence of a diagnostic and patient safety benefit for patients with breathing difficulties, assessment of the effect of medical treatment and capnography used as continuous monitoring. The article further discusses the prehospital use of capnography in Denmark and the possible advantages for its use in the Emergency Department. Conclusions After adequate training in its use, capnography seems to have potential in diagnostics and continuous monitoring of acute, non-intubated patients.