Esophageal intubation

Encyclopedia of capnograms

Bhavani Shankar Kodali MD

Esophageal intubation

Flat line as no carbon dioxide

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

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

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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.

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Lung transplant

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

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Severe Kyphoscoliosis

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

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Endobronchial intubation

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

 

 

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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

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