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A Comprehensive Educational Website (established 1998)

Designed, Produced, and maintained (Edition 12, 2022) by 

Bhavani Shankar Kodali MD

Updated September 2022

Esophageal intubation

Encyclopedia of capnograms

Bhavani Shankar Kodali MD

Esophageal intubation

Flat line as no carbon dioxide

esophageal.gif

 


Presence of CO2 in the stomach can give rise to fluctuations in the base line

esophageal1.gif


Occasionally enough alveolar gas can be forced down the esophagus into the stomach during mask ventilation resulting transiently in few capnograms as below

esophagealmask.gif

Details


Carbonated beverages in the stomach can result in significant CO2 in expired gases during six breaths. However, the shape of capnograms should alert to a non tracheal intubation.

carbonated.gif

Details

Lung transplant

Biphasic capnogram following single lung transplant suggesting characteristic differential emptying of each lung

lungtransplant.gif

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Severe Kyphoscoliosis

Biphasic capnogram in a patient with severe kyphoscoliosis. Differential emptying of lungs. Inspiration

kypho.gif

Details

Endobronchial intubation

Biphasic capnogram as a result of endotracheal tube in right main bronchus Endotracheal tube pulled back above tracheal carina

 

 

endobronch.gif

 

endobronch1.gif

Details

 

Downward sloping phase III

The slope of phase III can be reversed in patients with emphysema where there is marked destruction of alveolar capillary membranes and reduced gas exchange

emphysema.gif

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