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# Capnography

All about Capnography - 'The only dynamic text book on capnography' - Edited frequently - Explained with animations  -  Quarter century of capnography education  "Worldwide"

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## Posts

- [Bhavani Shankar Kodali](https://www.capnography.com/bhavani-shankar-kodali/) - Capnograph and video laryngoscope introduced for all codes at Brigham and Women's Hospital in 2012 Short Video of the Presentation Pictures of the Distinguished Award Presentation March 2025 Indian Journal of Anesthesiology Pod Cast https://www.youtube.com/watch?v=GZF9EM0xhhI&ab_channel=IndianJournalofAnaesthesia%28IJA%29 Curriculum Vitae Bhavani Shankar Kodali, M.D. Professor of Anesthesiology University of Maryland School of Medicine Date:
- [Capnography During Sedation - Teaching Module 2012](https://www.capnography.com/capnography-during-sedation-teaching-module/) - This is a powerpoint teaching presentation for capnography during sedation. The teaching module can be downloaded for teaching purposes. There are CME questions at the end of the module. Open the PowerPoint file as 'Read only File.' Powerpoint Presentation for 'capnography during sedation'. If you need a pdf format of the teaching module for printing
- [Capnography Lecture - David Whitaker,FRCA, FFPMRCA, FFICM, FCARCSI (Hon)](https://www.capnography.com/capnography-lecture-david-whitaker-frca-ffpmrca-fficm-fcarcsi-hon/) - This is a lecture presentation (PowerPoint) by Dr David Whitaker at the Difficult Airway Society, Nottingham, UK in 2011. This is read only file and will not allow edits. Press 'OK' on opening the file via download. Capnography Lecture - DSA Capnography Lecture - DSA zip file
- [Capnography Lecture Powerpoint - Bhavani Shankar Kodali MD](https://www.capnography.com/capnography-lecture/) - You can view this comprehensive PowerPoint presentation on capnography. This is read only file and will not allow edits. Press 'OK' on opening the file via download. You can also download zip file. Capnography PowerPoint Presentation Capnography PowerPoint Presentation zip file
- [96 minute of CPR with capnography](https://www.capnography.com/96-minute-of-cpr-with-capnography/) - During CPR, capnography does help to gauge the effectiveness of CPR. Effective CPR can facilitate enough cerebral and pulmonary circulation. The pulmonary circulation can be indirectly monitored by capnographic waveform and end-tidal carbon dioxide values. The following video illustrates the values of capnography during CPR. You can also see this as reported news on
- [Guidelines for monitoring pediatric patients for sedation-2016](https://www.capnography.com/guidelines-for-monitoring-pediatric-patients-for-sedation-2016-2/)
- [Guidelines for monitoring pediatric patients for sedation -2016](https://www.capnography.com/guidelines-for-monitoring-pediatric-patients-for-sedation-2016/) - The American Academy of Pediatrics, American Academy of Pediatric Dentistry released guidelines for monitoring and managing pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. This is an update and is current, as is in 2016 and published in Pediatrics 2016;138(1)e20161212. Clinical care providers are strongly encouraged to read the original publication Guidelines for monitoring pediatric patients for sedation -2016 - Capnography
- [Capnography - Closing the Gap on the Frontlines](https://www.capnography.com/capnography-closing-the-gap-on-the-frontlines/) - Anesthesia & Analgesia highlights the importance of capnography monitoring via a series of articles under important categories of the Journal. You can consider this edition as ‘Special Capnography Edition.’ Editorial: Global Capnography to Improve Safety for All Patients: Time for Urgent Action Ellen P. O’Sullivan, MBBCh, FRCA, FCAI,* Mary T. Nabukenya, MB,† and Mark Newton, MD‡ Key Points:
- [American Society of Anesthesiology Meeting San Francisco October 2023](https://www.capnography.com/american-society-of-anesthesiology-meeting-san-francisco-october-2023/) - Association of Obstetric Anesthesiology group presentations on Morbidity and Mortality in South East Asia and Ultrasound Assessment of Gastric Contents Pro Con Debate. A perspective of Morbidity and Mortality from Indo Anesthesia - Indonesia. Brigham and Women's Alumni Association of Obstetric Anesthesiology group presentations on Morbidity and Mortality at American Society of Anesthesiologist Annual Meeting October 2023 at San Francisco.
- [Visiting Professor lectures](https://www.capnography.com/visiting-professor-lectures/) - Mission: "Exposing the hidden clinical science within the carbon dioxide waveforms to enhance the safety of patients during anesthesia" In United States, I have given visiting Professor grand rounds lecture at Massachusetts General Hospital and Beth Israel Deaconess Medical Center, Boston (both Harvard affiliated hospitals), Duke University Medical School, North Carolina, University Medical and Dental
- [Association of Obstetric Anesthesiology, India Meeting 2023, Ahmedabad](https://www.capnography.com/association-of-obstetric-anesthesiology-india-meeting-2023-ahmedabad/)
- [Disclaimers Legal  Notice](https://www.capnography.com/disclaimers-legal-notice/) - Disclaimers Copyright Protection Capnography.com. All rights reserved. Reproduction in whole or in part in any form or medium without express written permission of Bhavani Shankar Kodali is prohibited. Disclaimer for Commercial Supporters Capnography.com does not have any commercial supporters, either financial, or technical, for producing and maintaining this site. Therefore the commercial supporters have no
- [Preparing the unit](https://www.capnography.com/preparing-the-unit/) - Capnography in Emergency Tracheal Intubations Bhavani Shankar Kodali MD Preparing the unit Hold the adaptor such that the broader end is down and the flat portion of upper end is to the right. Snap the adaptor into the unit. See following illustrations. Next - Capnography in Emergency Tracheal Intubations
- [Capnography in Emergency Tracheal Intubations](https://www.capnography.com/capnography-in-emergency-tracheal-intubations/) - Capnography in Emergency Tracheal Intubations Bhavani Shankar Kodali MD Majority of emergency intubations are performed in surroundings that are less than ideal circumstances as compared to those in operating rooms. Therefore all tracheal intubations should be confirmed for endotracheal placement. Esophageal intubation or misplaced endotracheal tube can result in unsuccessful resuscitation, or can result in
- [Capnography in Emergency Tracheal Intubations 3](https://www.capnography.com/capnography-in-emergency-tracheal-intubations-3/) - Capnography in Emergency Tracheal Intubations Bhavani Shankar Kodali MD The effectiveness of CPR can be judged by ETCO2 values. Consistently high ETCO2 values indicate well executed CPR. An ETCO2 higher than 19 mm Hg at the start of CPR has been associated with successful return of pulse. Furthermore, survivors had higher ETCO2 than non survivors
- [Capnography in Emergency Tracheal Intubations2](https://www.capnography.com/capnography-in-emergency-tracheal-intubations2/) - Capnography in Emergency Tracheal Intubations Bhavani Shankar Kodali MD The unit is ready in 5 seconds. Interpose the unit between the endotracheal tube / mask and the ambu bag Next
- [Capnography in Emergency Tracheal Intubations](https://www.capnography.com/capnography-in-emergency-tracheal-intubations-sp-2142616940/) - Capnography in Emergency Tracheal Intubations Bhavani Shankar Kodali MD Move the mouse cursor to 'ON Button' and click. The unit shuts off automatically when the disposable adaptor is removed.
- [Capnography in Mysore - ISA Meeting Southzone Meeting -2023](https://www.capnography.com/capnography-in-mysore-isa-meeting-southzone-meeting-2023/) - Dr. Ranjit Inaugurates the release of a 'Web Based Anesthesia Learning Modules', as well as a book format at the South zone ISA Annual Meeting, Mysore, 2023. Fur further information - www.raaonline.co.in Dr. Ranjit Inaugurates the release of a 'Web Based Anesthesia Learning Modules', as well as a book format at the South zone ISA Annual Meeting, Mysore, 2023. Fur further information - www.raaonline.co.in
- [Bahrain](https://www.capnography.com/bahrain/)
- [Ireland Meeting](https://www.capnography.com/irelandmeeting/)
- [Indonesia](https://www.capnography.com/indonesia/)
- [Hungary](https://www.capnography.com/hungary/)
- [Turkey](https://www.capnography.com/turkey/)
- [AOA Meetings in India](https://www.capnography.com/aoa-meetings-in-india/)
- [Pondicherry, India - Meeting](https://www.capnography.com/pondicherry-india-meeting/)
- [Mumbai Airway Meeting](https://www.capnography.com/mumbai-airway-meeting/)
- [Kuwait Anesthesia Meeting 2014](https://www.capnography.com/kuwait-anesthesia-meeting-2014/)
- [Japanese Society of Anesthesiologists 2017](https://www.capnography.com/japanese-society-of-anesthesiologists-2017/)
- [Udaipur Anesthesia and Obstetric Meeting 2015](https://www.capnography.com/udaipur-anesthesia-and-obstetric-meeting-2015/) - Lawrence Tsen at the Udaipur meeting
- [Association of Anesthesiologists,2012, India, New Delhi Meeting - Oration Lecture](https://www.capnography.com/association-of-anesthesiologists-2012-india-new-delhi-meeting-oration-lecture/) - Oration Lecture at the Association of Anesthesiologists,2012, India, New Delhi Meeting Obstetric Epidurals: Is Ensuring Safety the Most Difficult Task? Lawrence Tsen MD in New Delhi Andhra Education Society Higher Education School, New Delhi, School education from Kindergarten to 11th standard Lawrence Tsen and Bhavani Shankar Kodali at Rashtrapathi Bhavan, New Delhi In front of
- [Capnography in Emergency Room](https://www.capnography.com/capnography-in-emergency-room/) - Clinical Reviews in Emergency Medicine The Journal of Emergency Medicine, Vol. 53, No. 6, pp. 829–842, 2017 This clinical review highlights the value of capnography in Emergency Medicine. The following is the abstract and readers are encouraged to read the full text of the article from the Journal site. The authors conducted a literature search of
- [Capnography Education Module - Medtronics](https://www.capnography.com/capnography-education-module-medtronics/) - Capnograph manufacturers also provide clinical education on the use of end tidal carbon dioxide in intubated as well as non-intubated patients. The clinical education module can be accessed via their respective websites.
- [Sedation During Dental Procedures](https://www.capnography.com/sedation-during-dental-procedures/) - Sedation During Dental Procedures The following are the guidelines for sedation as per American Dental Association (ADA): " MODERATE SEDATION – a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. capnography in dental sedation
- [Capnography Versus Carotid Doppler During CPR](https://www.capnography.com/capnography-versus-carotid-doppler-during-cpr/) - Capnography Versus Carotid Doppler During CPR comparison of carotid doppler ultrasonography and capnography in evaluating the efficacy of cardiopulmonary resuscitation: The first study. Yilmaz G, Silcan M, Serin S, Caglar B, Erarslan Ö, Parlak İ. Am J Emerg Med. 2018 Jan 6. pii: S0735-6757(18)30022-6. doi: 10.1016/j.ajem.2018.01.022. [Epub ahead of print] PMID: 29321118 The end-tidal carbon dioxide (ETCO2)
- [Volume capnography: A narrative review](https://www.capnography.com/volume-capnography-a-narrative-review/) - Volume capnography: A narrative review Shubhangi Singh, Bhavani Shankar Kodali Department of Anesthesiology and Critical Care, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Volume capnography is the graph of expired carbon dioxide concentration against the expired volume. It often requires special and bulky equipment to be recorded. It can be used to
- [Indian Society of Anesthesiologists, 2017 Kolkota](https://www.capnography.com/indian-society-of-anesthesiologists-2017-kolkota/)
- [Association of Anesthesiologists,2017, India, Bengaluru Meeting](https://www.capnography.com/association-of-anesthesiologists-india-bengaluru-meeting/)
- [Barbados Examinership](https://www.capnography.com/barbados-examinership/) - Babados, capnography, Bhavani Kodali
- [Royal College of Anaesthetists - Educational Campaign on Capnography During CPR](https://www.capnography.com/royal-college-of-anaesthetists-educational-campaign-on-capnography-during-cpr/) - Royal College of Anaesthetists - Educational Campaign on Capnography During CPR No Trace = Wrong Place The Royal College of Anaesthetists (RCoA) and the Difficult Airway Society (DAS) have initiated a campaign 'No Trace = Wrong Place' during CPR. If there is no capnography waveform during CPR, the endotracheal tube is not in the trachea capnography, CPR
- [Capnography - Sub-Saharan Africa](https://www.capnography.com/capnography-sub-saharan-africa/) - Capnography in Sub-Saharan Africa A recent study, 'Global Capnography Project (GCAP): implementation of capnography in Malawi - an international anaesthesia quality improvement project’ published in the journal Anaesthesia (https://www.onlinelibrary.wiley.com/doi/10.1111/anae.14426) estimated that 11,000 potentially fatal anaesthetic accidents could be prevented every year by access to a simple breathing monitor, the Capnograph. The authors R. Jooste, F. Roberts, S. veterinary capnography
- [Capnography in Pediatric and Neonatal Intensive Care Units](https://www.capnography.com/capnography-in-pediatric-and-neonatal-intensive-care-units/) - Capnography in Pediatric and Neonatal Intensive Care Units Despite proven value of continuous capnography waveforms in operating rooms as continuous monitor of ventilation, perfusion, and ventilation perfusion status of the lungs, it has taken considerable time for Intensive Care Units (ICUs) to avail of benefits of capnography. Capnography is not only a monitor of airway
- [Volume Capnography in the Intensive Care Unit: Potential Clinical Applicaitons](https://www.capnography.com/volume-capnography-in-the-intensive-care-unit-potential-clinical-applicaitons/) - Kreit JW. Ann Am Thorac Soc. 2019 Feb 11. doi: 10.1513/AnnalsATS.201807-502CME. [Epub ahead of print] The abstract is as follows: It is a good article to read Volume capnography provides a non-invasive, continuous display of the fractional concentration or partial pressure of carbon dioxide versus exhaled volume. Derived measurements and calculations are influenced by changes in both ventilation and perfusion volume capnography, physiological dead space
- [ASA Standards for 2011 - Capnography](https://www.capnography.com/asa-standards-for-2011/) - ASA Standards Revised for Ventiltion Bhavani Shankar Kodali MD American Society of Anesthesiologists (ASA) recently updated monitoring standards for ventilation that are defined below. Details of the 'Standards' can be found at the end of this document. ----------------------------- In October 2010, the ASA House of Delegates approved a change to the ASA "Standards for Basic Anesthetic Monitoring". In
- [Time Capnogram/Respiratory Flow/Voume Capnogram /RQ Monitor - All-in-One](https://www.capnography.com/time-capnogram-respiratory-flow-voume-capnogram-rq-monitor-all-in-one/) - Time Capnogram/Respiratory Flow/Voume Capnogram /RQ Monitor - All-in-One Almost 20 years ago, I envisioned a capnograph that would enable respiratory flow rates over a time capnogram. This would clearly demarcate the inspiratory and expiratory phases of a time capnogram. The interpretation of capnograms becomes easier as any deformity of the wave form can be identified
- [Catastrophic sedation errors occur because capnography is not used](https://www.capnography.com/catastrophic-sedation-errors-occur-because-capnography-is-not-used/) - Catastrophic sedation errors occur because capnography is not used Alan D. Kaye, MD, PhD states in 'Anesthesiology News' that inadequate monitoring during sedation continues to contribute to morbidity and mortality. He emphasizes that there is a real disconnect between the established guidelines and individual practices. One begins to wonder why providers are reluctant to use
- [Arterial to end-tidal carbon dioxide pressure difference during laparoscopic surgery in pregnancy](https://www.capnography.com/1825/) - Laparoscopic surgery in pregnancy Bhavani Shankar et al. (Kodali) Anesthesiology 2000;93(2):370-3. Capnography is adequate to guide ventilation during laparoscopic surgery in pregnant patients. Respiratory acidosis did not occur when PetCO2 was maintained at 32 mmHg during carbon dioxide pneumoperitoneum.The mean +/- SD for PaCO2--PetCO2 was 2.4 +/- 1.5 before carbon dioxide pneumoperitoneum, 2.6 +/- 1.2 pregnancy; laparoscopic surgery; capnography
- [Capnodynamic cardiac output](https://www.capnography.com/cardiac-output-monitoring/) - Capnodynamic Cardiac Output (Dynamic capngraphy) Cardiac output monitoring is gaining increased importance in pediatric anesthesia and intensive care.(1) Karlsson et al (2) investigated effective pulmonary blood flow (COEPBG) technique in pediatric surgical patients, compared with suprasternal two-dimensional Doppler (COSSD). COEPBF was measured continuously using the differential Fick’s principle. The method is based on the differential Fick principle cardiac output and end tidal carbon dioxide or CO2
- [INTUB Study JAMA 2021](https://www.capnography.com/intub-study-jama-2021/) - INTUB study finds low use of capnography during tracheal intubation. This is disheartening. JAMA. 2021;325(12):1164-1172 Two new studies suggest wide international variation in intubation and extubation practices and associated adverse events among critically ill patients receiving mechanical ventilation. "Variability can only be leveraged and addressed once its existence is laid bare for all to see.
- [h clipart 1](https://www.capnography.com/h-clipart-1/) - This capnogram was recorded when the inspiratory valve of circle system was totally incompetent. The alveolar plateau is prolonged due to rebreathing of CO2. Initial inspiratory CO2 concentration was same as expiratory. Later FGF reduces the inspiratory CO2 concentration. Red is the inspiratory portion of the capnogram.
- [inspiratory](https://www.capnography.com/inspiratory/) - Inspiratory Unidirectional Valve Displaced Inspiratory valve Close up view Normal Inspiratory valve function =CO2 Inspiratory valve Incompetent Plateau is prolonged due to rebreathing Plateau is prolonged due to rebreathing An incompetent inspiratory valve will allow exhaled CO2- containing gas to enter the inspiratory limb of the circuit during expiration. During the Inspiratory valve dysfunction, rebreathing capnogram
- [From (a-ET)PCO2 gradients or differences- Alveolar dead space](https://www.capnography.com/from-a-etpco2-gradients-or-differences-alveolar-dead-space/) - Clinical Aspects Kodali. Bhavani Shankar MD (a-ET)PCO2 gradients or differences- Alveolar dead space There are three important applications of (a-ET)CO2 differences. Monitoring PaCO2 Measurements of PETCO2 constitute a useful non-invasive tool to monitor PaC02 and hence the ventilatory status of patients during anesthesia or in the intensive care unit. In normal individuals, the (a-ET)PC02 may clinical applications of capnography
- [Awards Bhavani Shankar Kodali MBBS, MD, FASA](https://www.capnography.com/recipient-of-pga-special-award/) - Dr. Bhavani Shankar Kodali from Brigham and Women's Hospital in Boston receives a 2002 Special Award for his exhibit titled "Education in the New Millennium" at the 56th Post Graduate Assembly in Anesthesiology held December 6-10, 2002 at the Hilton New York. This educational website was also presented at the American Society of Anesthesiologists
- [Capnography tips  main1](https://www.capnography.com/capnography-tips-main1/) - Capnography tips Bhavani Shankar Kodali MD Discipline is the key to success. In anesthesia practice, this translates to a global assessment of a problem in resolving an anesthesia crisis. Let capnography play its role in helping you to reach a diagnosis as quickly as possible. You can derive maximum benefit from the science of capnography
- [Chemical Method of Carbon dioxide Measurement](https://www.capnography.com/chemical-method-of-carbon-dioxide-measurement/) - Physics of Capnography Bhavani Shankar Kodali MD Chemical method of CO2 measurement A pH-sensitive chemical indicator changes color on exposure to CO2 FEF end-tidal detector: A pH-sensitive chemical indicator is enclosed in a plastic housing and is connected to the gas stream between the endotracheal tube and the anesthesia circuit. The pH sensitive indicator changes
- [Capnography during thoracic anesthesia](https://www.capnography.com/capnography-during-thoracic-anesthesia-sp-1076504805/) - Capnography as a non invasive-monitor of PaCO2 during thoracic anesthesia Bhavani Shankar Kodali MD The arterial to end-tidal PCO2 difference is dependent on the underlying pulmonary disease. The most common reason for thoracotomy in adults is surgical treatment of lung cancer. Patients with lung cancer are almost exclusively smokers, and therefore have airways disease, and
- [Photoacoustic Spectrography](https://www.capnography.com/photoacoustic-spectrography/) - Photo acoustic Spectrography Photoacoustic gas measurement (e.g., Bruel-Kjaer gas monitor)is based on the same principles as conventional IR-based gas analyzers: the ability of CO2 and N20 and anaesthetic agents to absorb IR light. However, they differ in measurement techniques. While Infra-red spectrography uses optical methods, PAS uses an acoustic technique. When an IR energy is
- [details 1](https://www.capnography.com/details-1/) - There is downward flip on the plateau. This capnogram was recorded when the inspiratory valve of circle system was not falling back completely into the seat, thereby resulting in partial rebreathing. Red indicates the inspiratory portion of the capnogram.
- [Microstream technology](https://www.capnography.com/microstream-technology-2/) - Physics of capnography Bhavani Shankar Kodali MD Microstream Technology Advantages Side stream capnometers using low aspiration flow rates (50ml.min-1) Minimizes dispersion of gases in the sampling tubes Less likely to aspirate condensed water and secretions thereby minimizing chances of occlusion Despite low flows, the response time is preserved by using highly CO2-specific infrared source and
- [Inspiratory valve defects Details](https://www.capnography.com/inspiratory-valve-defects-details-sp-937233631/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD There is downward flip on the plateau. This capnogram was recorded when the inspiratory valve of circle system was not falling back completely into the seat, thereby resulting in partial rebreathing. Red indicates the inspiratory portion of the capnogram.
- [t true 1](https://www.capnography.com/t-true-1/) - LMA and Capnography PETCO2 measured via LMA or ETT correlate well with PaCO2 during mechanical ventilation in children as well as in adults breathing spontaneously PETCO2 measured via ET tube PETCO2 measured via LMA During spontaneous ventilation in adults, the mean difference between PaCO2 and PETCO2 measured via LMA is similar to that
- [Endobronchial intubation (EBI)](https://www.capnography.com/endobronchial-intubation-ebi/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Endobronchial intubation (EBI) One of the common questions asked by residents is what happens to PETCO2 and capnogram during endobronchial Endobronchial Intubation (EBI)?. Capnography is not a sensitive diagnostic tool of endobronchial intubation (EBI). A study comparing capnography with pulse oximetry in children, showed that pulse oximetry provided
- [Capno Quiz/Clip Arts : Page 3](https://www.capnography.com/capno-quizclip-arts-page-3/) - Capno-Quiz-Clip Arts Bhavani Shankar Kodali MD Do you understand capnography ? Check yourself R In endobronchial intubation: (a) The height of the capnogram is increased (b) The height of the capnogram is decreased (c) Biphasic waveform can occur (d) There may not be any change in the capnogram (e) The capnogram may have prolonged phase
- [Capno Quiz Clip Arts : Page 2](https://www.capnography.com/capno-quiz-clip-arts-page-2/) - Capno-Quiz-Clip arts Bhavani Shankar Kodali MD Do you understand capnography? Check yourself This section can be used in two ways. If you saw a capnogram in the operating room today and you want to know what it is, identify the shape of the capnogram below and place the cursor over it to know the details.
- [p true](https://www.capnography.com/p-true/) - This animation shows how end-tidal PCO2 changes with decreases in cardiac output.
- [o clipart 2](https://www.capnography.com/o-clipart-2/) - A Flat Line This may happen under the following circumstances: Monitor has been just turned on and it is warming up. Monitor periodically zeroes itself. Most units display 'zeroing' during this process. Esophageal intubation Accidental extubation Apnea Circuit disconnection Cardiac arrest Sampling tube disconnection.
- [n cliart](https://www.capnography.com/n-cliart/) - Esophageal intubation following a mask ventilation Occasionally enough alveolar gas can be forced down the esophagus into the stomach during mask ventilation resulting transiently in few capnograms as shown above. The concentration of carbon dioxide falls dramatically after three breaths and to zero in about six breaths. However, a careful analysis of capnograms should alert
- [m clipart 2](https://www.capnography.com/m-clipart-2/) - Inspiratory Unidirectional Valve Displaced Inspiratory valve
- [m clipart 1](https://www.capnography.com/m-clipart-1/) - Expiratory Unidirectional valve Expiratory valve - Normal Incompetent expiratory valve The capnogram shows prolonged phase II as well as slanting of descending limb of inspiratory segement. The expiratory unidirectional valve was noted to be fixed in the open position and thus allowing previously exhaled gases,
- [Esophageal intubation (2)](https://www.capnography.com/esophageal-intubation-2/) - Presence of CO2 in the stomach can give rise to fluctuations in the base line
- [emphysema](https://www.capnography.com/esophageal-intubation-3/) - 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
- [k  clipart 2](https://www.capnography.com/k-clipart-2/) - The case report on "Failure To Detect CO2-absorbent Exaustion: Seeing and Believing" by Pond et al is an interesting reading.1 However, the interpretation of the abnormal capnogram as obtained by the authors (figure above) warrants further analysis. First of all, the differential diagnosis of the abnormal capnogram could be a curare cleft capnogram (if the
- [k  clipart 1](https://www.capnography.com/k-clipart-1/) - Esophageal intubation and carbonated beverages Occasionally, an end-expired level of 2.5% (17-18 mm Hg, highest observed measurement in swine study was 38-39 mm Hg) or more may be observed in first six breaths during esophageal intubation in the presence of carbonated beverages in the stomach. However, the shape of the capnograms appear abnormal and should
- [j clipart yes](https://www.capnography.com/j-clipart-yes/) - Capnograms recorded in infants and children using side-stream capnographs. Distortion in CO2 waveforms as a result of dispersion of gases in the sampling line. Phase II and the descending limb can be prolonged. Base line is elevated and phase III can have increased slope. References 1. Pascucci RC, Schena JA, Thompson JE. Comparison
- [i clipart 2](https://www.capnography.com/i-clipart-2/) - Capnograms were recorded in infants and children using side-stream capnography. Distortion in CO2 waveforms as a result of dispersion of gases in the sampling line. Phase II and the descending limb can be prolonged. The baseline is elevated, and phase III can have an increased slope.
- [i clipart 1](https://www.capnography.com/i-clipart-1/) - The terminal upswing towards the end of the expiratory plateau. This occurs in pregnant and obese patients during anesthesia and IPPV.
- [h clipart 2](https://www.capnography.com/h-clipart-2/) - This capnogram was recorded during low-frequency controlled ventilation. Cardiogenic oscillations are shown during the expiratory plateau, and the descending limb waveform occurs as a result of the movement of gases in the airway due to cardiac pulsations.
- [o clipart 1](https://www.capnography.com/o-clipart-1/) - Lung transplant Biphasic capnogram recorded in a patient after single lung transplantation. This is due to different populations of alveoli. The first peak represents expired carbon dioxide from an allografted lung, which has normal compliance, good perfusion, and good ventilation-perfusion ratios (V/Q). The second peak most likely reflects expired carbon dioxide from the native lung
- [g clipart 2](https://www.capnography.com/g-clipart-2/) - There is a downward flip on the plateau. This capnogram was recorded when the inspiratory valve of the circle system was not falling back entirely into the seat, resulting in partial rebreathing. Red indicates the inspiratory portion of the capnogram.
- [g clipart 1](https://www.capnography.com/g-clipart-1/) - IMV capnogram IMV breath interposed during spontaneous ventilation. Relative comparison between the heights of spontaneous breath capnogram and the heights of IMV capnograms gives an indication of spontaneous respiratory efforts.
- [f clipart 2](https://www.capnography.com/f-clipart-2/) - Signature capnogram Capnogram recorded during the use of Bain anesthetic system / Mapelson D. The base line is elevated from zero. During inspiration, there a small rebreathing wave due to inhalation of carbon dioxide. The extent of CO2 rebreathing depends FGF, tidal volume, and respiratory frequency. Red indicates inspiration. A similar capnogram has been
- [f clipart 1](https://www.capnography.com/f-clipart-1/) - Rebreathing The baseline is elevated from zero. It probably indicates exhaustion of soda lime.
- [e clipart 2](https://www.capnography.com/e-clipart-2/) - Bronchospasm The slope of phase III is increased, and phase II is prolonged. After the treatment, the capnogram is normalized—a similar picture results in children when a side stream analyzer with a longer response time is used.
- [e clipart 1](https://www.capnography.com/e-clipart-1/) - Capnogram recorded during general anesthesia for cesarean section. The slope of phase III is increased. This is a normal physiological variation. Airway obstruction can result in an increase in phase III as well. Phase II can also be prolonged depending on the severity of airway obstruction. A phase IV can occur in capnograms recorded during
- [d clipart 2](https://www.capnography.com/d-clipart-2/) - Hypoventilation There is a progressively increasing end-tidal PCO2 value. The baseline remains at zero. The shape of the waveform remains normal.
- [d clipart 1](https://www.capnography.com/d-clipart-1/) - Cardiac arrest, successful resuscitation This trend capnogram shows progressive cardiac output decreases, culminating in cardiac arrest. Successful resuscitation increased cardiac output, leading to progressive increases in end-tidal carbon dioxide.
- [c clipart 2](https://www.capnography.com/c-clipart-2/) - Contamination of CO2 sensor This is a trend capnogram showing a sudden increase in the baseline as well as the height of the waveform and indicates contamination of the carbon dioxide analyzer.
- [Dual waveform capnogram](https://www.capnography.com/dual-waveform-capnogram/) - Dual waveform capnogram This capnogram occurs due to sampling leaks in the sampling tube cracks or a loose connection between the sampling tubes and the monitor. It has also been reported due to breaks in the water filter of the carbon dioxide analyzer. (Provided by Simon Body and James Philips) This shape of a capnogram
- [c clipart 1](https://www.capnography.com/c-clipart-1/) - Hyperventilation capnogram During hyperventilation, base line remains at zero. However, the height of the capnograms decreases gradually. Progressive depression of cardiac out or metabolism can also decrease the height of the capnograms.
- [b clipart 1](https://www.capnography.com/b-clipart-1/) - This is a capnogram seen during general anesthesia and muscle relaxants. The cleft on the alveolar plateau is due to spontaneous respiratory effort. Occasionally surgical manipulation in the abdomen or surgeon leaning on the chest can produce a similar capnogram.
- [a clipart 2](https://www.capnography.com/a-clipart-2/) - This is a capnogram seen commonly during spontaneous ventilation in children. In adults, generally seen during sampling from oxygen mask or nasal cannula.
- [q decrease](https://www.capnography.com/q-decrease/) - This animation shows how end-tidal PCO2 changes with air embolism. Alveolar dead space is increased.
- [q increase 2](https://www.capnography.com/q-increase-2/) - This animation shows how end-tidal PCO2 changes with air embolism. Alveolar dead space is increased.
- [r true 1](https://www.capnography.com/r-true-1/) - Endobronchial Intubation The characteristic features of capnogram in endobronchial intubation are dependent on the extent of endobronchial intubation. The ETCO2 can increase if the consequent one lung ventilation results in hypoventilation. On the other hand, if the tube is far down resulting in over all reduced ventilation (small tidal volumes), then ETCO2 can decrease (not
- [s true 1](https://www.capnography.com/s-true-1/) - Venous CO2embolism End-tidal CO2 monitoring is essential during laparoscopy, as it may help in the early detection of venous CO2 embolism (accidental insufflation of CO2 into the veins). In addition, CO2 is also absorbed from abdominal cavity. A transient but rapid rise in PETCO2, has been suggested as a useful early sign of venous CO2
- [a clipart 1](https://www.capnography.com/a-clipart-1/) - This is a normal capnogram seen commonly during controlled ventilation or spontaneous ventilation.
- [Capno Quiz Clip Arts](https://www.capnography.com/capno-quiz-clip-arts/) - Capno-Quiz - Clip Arts Bhavani Shankar Kodali MD Do you understand capnography? Check yourself This section can be used in two ways. If you saw a capnogram in the operating room today and want to know what it is, identify the shape of the capnogram below and double-click for a separate window showing details. or,
- [Endobronchial intubation (EBI)](https://www.capnography.com/endobronchial-intubation-ebi-2/) - Endobronchial intubation (EBI) One of the common questions asked by residents is what happens to PETco2 and capnogram during endobronchial Endobronchial Intubation (EBI)?. Capnography is not a sensitive diagnostic tool of endobronchial intubation (EBI). A study comparing capnography with pulse oximetry in children, showed that pulse oximetry provided the first diagnostic clue in 13 of
- [Endobronchial intubation (EBI)](https://www.capnography.com/endobronchial-intubation-ebi-3/) - Endobronchial intubation (EBI) One of the common questions asked by residents is what happens to PETco2 and capnogram during endobronchial Endobronchial Intubation (EBI)?. Capnography is not a sensitive diagnostic tool of endobronchial intubation (EBI). A study comparing capnography with pulse oximetry in children, showed that pulse oximetry provided the first diagnostic clue in 13 of
- [This is another capnogram which may not be an infrequent occurrence](https://www.capnography.com/this-is-another-capnogram-which-may-not-be-an-infrequent-occurrence/) - There is downward flip on the plateau. This capnogram was recorded when the inspiratory valve of circle system was not falling back completely into the seat, thereby resulting in partial rebreathing. Red indicates the inspiratory portion of the capnogram.
- [LMA and Capnography](https://www.capnography.com/lma-and-capnography/) - Clinical Aspects Bhavani Shankar Kodali MD LMA and Capnography PETCO2 measured via LMA or ETT correlate well with PaCO2 during mechanical ventilation in children as well as in adults breathing spontaneously PETCO2 measured via ET tube PETCO2 measured via LMA During spontaneous ventilation in adults, the mean difference between PaCO2 and PETCO2 measured via
- [LMA and Capnography](https://www.capnography.com/lma-and-capnography-3/) - LMA and Capnography PETco2 measured via LMA or ETT correlate well with Paco2 during mechanical ventilation in children as well as in adults breathing spontaneously PETco2 measured via ET tube PETco2 measured via LMA During spontaneous ventilation in adults, the mean difference between Paco2 and PETco2 measured via LMA is similar to that measured via
- [Endobronchial intubation](https://www.capnography.com/endobronchial-intubation/) - Endobronchial intubation Right mainstem intubation Endotracheal tube pulled back into the trachea A biphasic carbon dioxide elimination waveform recorded in a patient with no known lung disease who was found to have a right main-stem bronchial intubation. This capnogram probably occurred as the tip of the endotracheal tube changed moved in out of right
- [Biphasic carbon dioxide waveform in severe kyphoscoliosis](https://www.capnography.com/biphasic-carbon-dioxide-waveform-in-severe-kyphoscoliosis/) - Biphasic carbon dioxide waveform in severe kyphoscoliosis Carbon dioxide waveform recorded in a patient with severe kypho-scoliosis. The CO2 waveform has two humps. Kyphoscoliosis resulted in a compression of the right lung. The compressed right lung had a relatively high airway resistance, was poorly ventilated, and was relatively hypercapnic, whereas the left lung had a
- [Lung transplant](https://www.capnography.com/lung-transplant/) - Biphasic capnogram recorded in a patient after single lung transplantation. This is due to different populations of alveoli. The first peak represents expired carbon dioxide from allografted lung, which has normal compliance, good perfusion, and good ventilation-perfusion ratios (V/Q). The second peak most likely reflects expired carbon dioxide from the native lung, because of slanted
- [Esophageal intubation and carbonated beverages](https://www.capnography.com/esophageal-intubation-and-carbonated-beverages/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Esophageal intubation and carbonated beverages Occasionally, an end-expired level of 2.5% (17-18 mm Hg, highest observed measurement in swine study was 38-39 mm Hg) or more may be observed in first six breaths during esophageal intubation in the presence of carbonated beverages in the stomach. However, the shape
- [Esophageal intubation following a mask ventilation](https://www.capnography.com/esophageal-intubation-following-a-mask-ventilation/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Esophageal intubation following a mask ventilation Occasionally enough alveolar gas can be forced down the esophagus into the stomach during mask ventilation resulting transiently in few capnograms as shown above. The concentration of carbon dioxide falls dramatically after three breaths and to zero in about six breaths. However,
- [Expiratory valve stuck open Details](https://www.capnography.com/expiratory-valve-stuck-open-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Expiratory Unidirectional valve Expiratory valve - Normal Incompetent expiratory valve The capnogram shows prolonged phase II as well as slanting of descending limb of inspiratory segement. The expiratory unidirectional valve was noted to be fixed in the open position and thus allowing previously exhaled gases, high in CO2,
- [Partial disconnection of main stream sensor (like curare cleft) Details](https://www.capnography.com/partial-disconnection-of-main-stream-sensor-like-curare-cleft-details/) - Curare cleft Bhavani Shankar Kodali MD Curare Cleft as a result of partial disconnection of main stream CO2 sensor Tripathi et al reported that a partial disconnect of a main stream capnometer also can present a "cleft" on the expiratory plateau during controlled ventilation. After induction of anesthesia, they noticed a "cleft" ( a sudden
- [Sampling leaks -Breakage in the sampling filter Details](https://www.capnography.com/sampling-leaks-breakage-in-the-sampling-filter-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Dual Plateau capnogram caused by cracked sample filter A dual plateau capnogram was observed by Body et al during anesthesia and IPPV. They found that the cause of the abnormality was due a microscopic crack in the filter membrane separator cartridge of the Ohmeda RGM 5250 gas analyzer.
- [Cardiac output and capnograms Details](https://www.capnography.com/cardiac-output-and-capnograms-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD How does cardiac output affect PETCO2 Increases in cardiac output and pulmonary blood flow result in better perfusion of the alveoli and a rise in PETCO2. Under conditions of constant lung ventilation, PETCO2 monitoring can be used as a monitor of pulmonary blood flow Cardiac
- [Inspiratory valve malfunction Details](https://www.capnography.com/inspiratory-valve-malfunction-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD spiratory Unidirectional Valve Displaced Inspiratory valve Close up view Normal Inspiratory valve function=CO2 Inspiratory valve Incompetent Plateau is prolonged due to rebreathing An incompetent inspiratory valve will allow exhaled CO2- containing gas to enter the inspiratory limb of the circuit during expiration. During the next inspiration, the CO2-containing
- [Inspiration Details](https://www.capnography.com/inspiration-details-2/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD The case report on "Failure To Detect CO2-absorbent Exaustion: Seeing and Believing" by Pond et al is an interesting reading.1 However, the interpretation of the abnormal capnogram as obtained by the authors (figure above) warrants further analysis. First of all, the differential diagnosis of the abnormal capnogram
- [Bain anesthetic system or Mapelson D circuit Details](https://www.capnography.com/bain-anesthetic-system-or-mapelson-d-circuit-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Signature capnogram Capnogram recorded during the use of Bain anesthetic system / Mapelson D. The base line is elevated from zero. During inspiration, there a small rebreathing wave due to inhalation of carbon dioxide. The extent of CO2 rebreathing depends FGF, tidal volume, and respiratory frequency.
- [Capnograms in pediatrics Details](https://www.capnography.com/capnograms-in-pediatrics-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Capnograms recorded in infants and children using side-stream capnographs. Distortion in CO2 waveforms as a result of dispersion of gases in the sampling line. Phase II and the descending limb can be prolonged. Base line is elevated and phase III can have increased slope. References 1.Pascucci RC, Schena
- [Capnograms in pregnancy Details](https://www.capnography.com/capnograms-in-pregnancy-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Capnogram recorded during general anesthesia for cesarean section The slope of the phase III is increased. This is a normal physiological variation. Airway obstruction can result in an increase in the phase III as well. Depending on the severity of airway obstruction, phase II can also be prolonged.
- [PETCO2 as an estimate of PaC02](https://www.capnography.com/petco2-as-an-estimate-of-pac02/) - Clinical Aspects Bhavani Shankar Kodali MD ( I ) PETCO2 as an estimate of PaC02 Measurements of PETCO2 constitute a useful non-invasive tool to monitor PaC02 and hence the ventilatory status of patients during anesthesia or in the intensive care unit. In normal individuals, the (a-ET)PC02 may vary from 2-5 mmHg.1-5 It can vary from
- [Applications/Clinical uses of Capnography](https://www.capnography.com/applicationsclinical-uses-of-capnography/) - Clinical uses of capnography Bhavani Shankar Kodali MD PETCO2 as an estimate of PaC02 Detection of pulmonary air embolism Adequacy of spontaneous respiration Pulmonary thrombo-embolism Integrity of anesthetic apparatus Venous C02 embolism Adjustments of fresh gas flow rates (FGF) in rebreathing systems Hypermetabolic states Accidental esophageal intubation Cardiopulmonary resuscitation Blind nasal intubation High frequency jet
- [CPR mobile code stand with capnograph at Brigham and Women's Hospital](https://www.capnography.com/cpr-mobile-code-stand-with-capnograph-at-brigham-and-women-s-hospital/) - CPR Mobile Code Stand At Brigham and Women’s Hospital, Boston, MA, USA, a mobile code stand equipped with a portable capnograph follows the anesthesiologist. The capnograph unit is switched on as soon as a code call is initiated. By the time the code team reaches the code area, the capnograph unit is functionally ready. The
- [Capnography in Cardiopulmonary Resuscitation (CPR) 2012](https://www.capnography.com/capnography-in-cardiopulmonary-resuscitation-cpr/) - The following module is for teaching the role of capnography in CPR. The module can be downloaded and used for teaching purposes. There is a question module at the end of the teaching course. Open the PowerPoint as 'Read only File' Capnography in CPR - Teaching Module For Pdf file on 'capnography in CPR' for distribution,
- [Frequently asked questions in capnography](https://www.capnography.com/frequently-asked-questions-in-capnography/) - This section was added because many readers asked the following questions, particularly exam going students. Clicking on 'detail' sign, will go to the new window. Close the window to proceed with the next one. {slider 1. How does capnography reflect endobronchial intubation?} Detail { slider 2. Is there a relation between cardiac output and PETCO2?} Detail
- [MicroRotor technology](https://www.capnography.com/microrotor-technology/) - As capnography establishes its rightful place for monitoring ventilation during sedation in many surgical and medical specialties,researches are continuing to explore newer methods of carbon dioxide measurement and monitoring. Recently, another newer method, ultra-compact MicroRotor technology, was introduced to measure CO2, nitrous oxide and the five anesthetic agents. The technology is used in either mainstream
- [Cardiac Output Measurement](https://www.capnography.com/cardiac-output-measurement/) - New Technology In Capnography Kodali. Bhavani Shankar MD Non invasive measurement / monitoring of cardiac output: Recently, based on the well-known accepted Fick's Principle, Novametrix introduced NICO (Novametrix NICO®) cardiac output measurement device that uses partial CO2 breathing to determine cardiac output non-invasively. The NICO® Cardiopulmonary Management System provides continual cardiac output monitoring. With this
- [Capnograph of the millennium](https://www.capnography.com/capnograph-of-the-millennium/) - Capnograph of this millennium A vision to reality Bhavani Shankar Kodali. MD A vision of an ideal capnograph - Dated November 2000 A side stream capnograph with the advantages of the mainstream capnograph seems ideal. Inspiratory and expiratory flow rates should be displayed above the co2 waveforms to delineate segments and phases of capnogram
- [Advances in main-stream sensor technology](https://www.capnography.com/advances-in-main-stream-sensor-technology/) - Physics of capnography Bhavani Shankar Kodali MD Advances in main-stream sensor technology New developments in mainstream sensor technology have overcome many disadvantages associated with earlier models, such as heavy weight, bulky size, facial burns as a result of heated sensors, and increased drag on the endotracheal tubes. In addition, an aspiration sampling pump has been
- [Microstream technology](https://www.capnography.com/microstream-technology/) - Physics of capnography Bhavani Shankar Kodali MD Microstream Technology Advantages Side stream capnometers using low aspiration flow rates (50ml.min-1) Minimizes dispersion of gases in the sampling tubes Less likely to aspirate condensed water and secretions thereby minimizing chances of occlusion Despite low flows, the response time is preserved by using highly CO2-specific infrared source and
- [Tips on using capnography- Abnormal values and shapes](https://www.capnography.com/tips-on-using-capnography-abnormal-values-and-shapes/) - Capnography tips Bhavani Shankar Kodali MD Tips on using capnography- Abnormal values and shapes The following guidelines can be used to assess abnormal capnograms. However, a thorough understanding of underlying principles of capnography will to help you to maximize the benefit of capnography in rectifying a clinical abnormality during anesthesia. 1. Rule out technical causes
- [Minimize technical problems in CO2 sampling](https://www.capnography.com/minimize-technical-problems-in-co2-sampling/) - Capnography tips Bhavani Shankar Kodali MD Minimize technical problems in CO2 sampling FGF can dilute PETCO2 measurements. A Right angle connection between the breathing system and the sampling tube increases the accuracy of PETCO2 measurements as shown below Right angle connection between the breathing system and the sampling tube increases the accuracy of PETCO2 measurements
- [Capnography in Emergency Tracheal Intubations](https://www.capnography.com/capnography-in-emergency-tracheal-intubations-2/) - Capnography in Emergency Tracheal Intubations Bhavani Shankar Kodali MD Majority of emergency intubations are performed in surroundings that are less than ideal circumstances as compared to those in operating rooms. Therefore all tracheal intubations should be confirmed for endotracheal placement. Esophageal intubation or misplaced endotracheal tube can result in unsuccessful resuscitation, or can result in
- [outside of hospitals settings](https://www.capnography.com/outside-of-hospitals-settings/) - Capnography In "Outside of Hospital Settings" - 911 Venkatesh Srinivasa MD & Bhavani Shankar Kodali MD Physiologically, CO2 produced in the tissues and diffuse into the venous blood which reaches the right side of the heart and reaches the lungs via pulmonary circulation. Here oxygen (O2) enters the blood and carbon dioxide (CO2) is given
- [capnography in 911](https://www.capnography.com/capnography-in-911/) - Capnography In "Outside of Hospital Settings" - 911 Venkatesh Srinivasa MD & Bhavani Shankar Kodali MD
- [How do you use capnography during sedation - Bhavani Kodali's algorithm](https://www.capnography.com/how-do-you-use-capnography-during-sedation-bhavani-kodali-s-algorithm/) - There are many methods to sample respiratory gases in order to measure exhaled carbon dioxide. Some are commercially available devices; others are innovative methods designed to achieve the ultimate goal of adequately sampling exhaled gases. I use the nasal cannula to sample exhaled gases, by using a disposable nasal CO2 sampling device. A separate oxygen
- [Challenges of capnography during sedation](https://www.capnography.com/challenges-of-capnography-during-sedation/) - Challenges of monitoring ventilation with capnography There are few challenges encountered in obtaining effective benefits of capnography during sedation. Nonetheless the challenges are surmountable with understanding of principles of capnography. The challenges include difficulties in sampling of expired gases, interpretation of capnograms, training personnels and economic impact related to equipment and disposables. Using capnography during
- [Capnograms during procedural sedation](https://www.capnography.com/capnograms-during-procedural-sedation/) - Capnograms during procedural sedation Bhavani Shankar Kodali MD Carbon dioxide wave forms may not be as perfect in shape as those obtained in intubated patients (1-4). However, a change form baseline capnograms during procedural sedation may indicate increased depth of sedation (5-7). In the least, one has to determine the cause of the change in
- [Carbon dioxide sampling methods during sedation](https://www.capnography.com/sampling-methods/) - There are many capnography sampling devices, available commercially, for clinical monitoring. The following are few samples to demonstrate their application Nasal sampling for end tidal carbon dioxide Nasal sampling for end tidal carbon dioxide Oral sampling end tidal carbon dioxide during endoscopy procedures sampling of end tidal carbon dioxide in children Sampling end tidal carbon
- [How to monitor ventilation](https://www.capnography.com/how-to-monitor-ventilation/) - Carbon dioxide sampling devices for procedural sedation Bhavani Shankar Kodali MD The devices for carbon dioxide sampling can be assembled from the items shown in pictures (1,2). Several varieties of end-tidal carbon dioxide sampling devices are available commercially (3). 1 2 3 (Visit Medtronics.com ) 4. Visit Mediplus Capnomask Click here for CO2 waveforms during
- [Guidelines for monitoring pediatric patients for sedation](https://www.capnography.com/guidelines-for-monitoring-pediatric-patients-for-sedation/) - The American Academy of Pediatrics, American Academy of Pediatric Dentistry released guidelines for monitoring and managing pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. This is an update and is current, as is in 2016 and published in Pediatrics 2016;138(1)e20161212. Clinical care providers are strongly encouraged to read the original publication cited
- [Monitored Anesthesia Care- Injury and Liability](https://www.capnography.com/monitored-anesthesia-care-injury-and-liability/) - Monitored Anesthesia Care- Injury and Liability The common belief is that monitored anesthesia care and sedation for procedures are not usually associated with morbidity, and mortality. This notion occasionally results in providing sedation for procedures without ensuring adequate monitoring. The findings of closed claims analysis of American Society of Anesthesiologists (ASA) are contradicts this common
- [Capnography is vital during sedation](https://www.capnography.com/capnography-is-vital-during-sedation/) - Capnography During Sedation Venkatesh Srinivasa MD & Bhavani Shankar Kodali MD The line of demarcation between conscious sedation and general anesthesia is sometimes very thin. It is possible during conscious sedation, intravenous sedatives and narcotics administered to allay apprehension can result in the loss of consciousness and respiratory obstruction. If this is not recognized immediately,
- [Concerns during sedation](https://www.capnography.com/concerns-during-sedation/) - Capnography during conscious or procedural sedation -What is the present concern? Bhavani Shankar Kodali MD Propofol and other sedatives, although administered in good faith to produce conscious or light sedation, can often result in inadvertent deep sedation comparable to general anesthesia.(1,2) in a study by Ramsay etal, the authors observed that 74% of their patients
- [Capnography in Veterinary Sedation](https://www.capnography.com/capnography-in-veterinary-sedation/) - Capnography in Veterinary Sedation It has been recognized that monitoring respirations in patients during sedation for out of the operating room procedures is valuable in preventing the occurrence of hypoxic episodes. The value of monitoring respirations using capnography has migrated to veterinary anesthesia to protect lives of precious animals. The picture below demonstrates the use
- [Capnography and Laparoscopy](https://www.capnography.com/capnography-and-laparoscopy/) - Capnography and Laparoscopy Bhavani Shankar Kodali MD Capnography has three important applications during laparoscopic surgery. 1. It serves as a non-invasive monitor of PaCO2 during CO2 insufflation and therefore can be used to adjust ventilation. 2. It may help in the detection of accidental intravascular CO2 insufflation. 3. It may help in the detection of
- [ Evaluation of ventilation/perfusion status of each lung - Dual capnography](https://www.capnography.com/capnography-during-thoracic-anesthesia-sp-222374589/) - Evaluation of ventilation/perfusion status of each lung (Dual lung capnography) Bhavani Shankar Kodali MDConventional capnography samples mixed expired gases, ie., gases from both the lungs. This approach would not be useful when one lung has a pathophysiologic defect. Dual capnography overcomes this limitation by sampling (measuring) gases from each lumen of a double-lumen tube (DLT).1,2The
- [Hemodynamic effects of carbon dioxide insufflation during thoracoscopy](https://www.capnography.com/capnography-during-thoracic-anesthesia-sp-1354505571/) - Hemodynamic effects of carbon dioxide insufflation during thoracoscopy. Bhavani Shankar Kodali MD Capnothorax As more complex thoracoscopic procedures are performed, adequate exposure becomes increasingly more important. The insufflation of CO2 has been demonstrated to aid in the compression of lung parenchyma and the effacement of subpleural lesions, and to act as a retractor when combined
- [Capnographic waveforms seen during thoracic anesthesia](https://www.capnography.com/capnography-during-thoracic-anesthesia-sp-449728275/) - Capnographic waveforms seen during thoracic anesthesia. Bhavani Shankar Kodali MD Abnormal CO2 waveforms that may be seen during thoracic anesthesia include: 1). Capnograms withincreased phase III slope due to a large spread V/Q ratios, as in lung disease. The initial part of the slope is represented by areas which are well ventilated with high V/Q
- [Capnography as a non invasive-monitor of PaCO2 during thoracic anesthesia](https://www.capnography.com/capnography-during-thoracic-anesthesia/) - Capnography during thoracic anesthesia Bhavani Shankar Kodali MD Capnography as a non-invasive-monitor of PaCO2 during thoracic anesthesia The arterial to end-tidal PCO2 difference is dependent on the underlying pulmonary disease. The most common reason for thoracotomy in adults is surgical treatment of lung cancer. Patients with lung cancer are almost exclusively smokers, and therefore
- [Capnography During Thoracic Anesthesia - Introduction](https://www.capnography.com/capnography-during-thoracic-anesthesia-sp-676686411/) - Bhavani Shankar Kodali MD In addition to the usual applications, there may be a specific role for capnography in thoracic anesthesia. The following issues will be addressed in this section. 1. Capnography as a non invasive monitor of PaCO2 during thoracic anesthesia. 2. Capnographic waveforms seen during thoracic anesthesia. 3. Evaluation of ventilation/perfusion status of
- [Pediatricians and Emergency Physicians](https://www.capnography.com/pediatricians-and-emergency-physicians/) - Capnography in Pediatrics Bhavani Shankar Kodali MD For physics and physiology of capnography, refer to appropriate sections. In the last two decades, measurement of carbon dioxide (CO2) in the expired air (capnography) has become increasingly popular in the operating room to monitor patients during anesthesia.1 Its use is strongly recommended in every patient requiring endotracheal
- [Anesthesoiologists](https://www.capnography.com/anesthesoiologists/) - Capnography in Pediatrics Bhavani Shankar Kodali MD CAPNOGRAPHY IN INFANTS AND SMALL CHILDREN Highlights 1. Interaction between physical and physiological factors results in normal variants in a capnogram (figure). 2. Main stream capnometers are more accurate than side stream capnometers for proximal site PETCO2 measurements,7 however main stream capnometers may cause unacceptable rebreathing.2,16 3. Distal
- [Capnography in Pediatrics](https://www.capnography.com/capnography-in-pediatrics/) - For Anesthesiologists For Pediatricians and Emergency Physicians
- [Anesthesia Breathing Systems](https://www.capnography.com/anesthesia-breathing-systems/) - Anesthesia Breathing Systems M Ravi Shankar MD and Bhavani Shankar Kodali MD M Ravi Shankar MD, Formerly Professor and Chair of Anesthesia, JIPMER, India, and presently Presently Professor and Chair of Anesthesiology, Mahatma Gandhi Medical College and Research Institute Pondicherry, India For a comprehensive understanding of 'Anesthesia breathing circuits,' click here for a review. It opens a new
- [Interpret your capnogram](https://www.capnography.com/interpret-your-capnogram/) - Interpret your capnogram Bhavani Shankar Kodali MD Compiled: by Ahalya Kodali MD This section provides a variety of capnograms put together in one group. Several E-mails have prompted us to compile this section. If you happen to see a capnogram and you wanted to know what the underlying cause is, this section should provide an
- [Carbon dioxide  Embolism](https://www.capnography.com/carbon-dioxide-embolism/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Carbon dioxide Embolism
- [Thrombo Embolism](https://www.capnography.com/thrombo-embolism/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Thrombo Embolism
- [Air Embolism](https://www.capnography.com/air-embolism/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Air Embolism
- [Esophageal intubation](https://www.capnography.com/esophageal-intubation/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Esophageal intubation Flatline as no carbon dioxide The presence of CO2 in the stomach can give rise to fluctuations in the baseline. Occasionally enough alveolar gas can be forced down the esophagus into the stomach during mask ventilation resulting transiently in a few capnograms as below. Details Carbonated
- [Equipment  malfunction](https://www.capnography.com/equipment-malfunction/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Equipment malfunction Sampling leaks Sampling tube leaks, Sampling via oxygen face mask, nasal cannula Sampling leaks Break in the sampling tube system or loose connections at sampling tube end of the monitor Sampling leaks -Breakage in the sampling filter Dual plateau capnogram Details Slit Sampling tube (tail-up
- [Rebreathing capnograms](https://www.capnography.com/rebreathing-capnograms/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Rebreathing capnograms Bain anesthetic system or Mapelson D circuit- Note the smaller inspiratory wave due to rebreathing - signature capnogram Details Exhausted Soda lime Gradual elevation of baseline and the height of the capnograms Baseline is elevated, but height can remain the same due to hyperventilation Baseline is
- [A Normal Capnogram in adult](https://www.capnography.com/a-normal-capnogram-in-adult/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD A Normal Capnogram in adult Capnograms in pregnancy Normal capnogram Capnogram with increased phase III slope Capnogram with phase IV Details Capnograms in pediatrics Capnograms in infants and children can have the following format under normal circumstances due to faster respiratory rates, smaller tidal volumes, and relatively
- [Encyclopedia of Capnograms](https://www.capnography.com/encyclopedia-of-capnograms/) - Capnograms Group 1 - Click here for the following capnograms Normal adult capnograms Pregnant capnograms Capnograms in infants and children Airway obstruction / Bronchospasm Ventilation Normal ventilation Spontaneous ventilation Hyperventilation Hypoventilation IMV Apnea Ripple effect Curare cleft Group 2 - Click here for the following capnograms Rebreathing capnograms Bain circuit/Mapelson D Exhausted soda lime Inspiratory valve
- [LMA and Capnography](https://www.capnography.com/lma-and-capnography-2/) - LMA and Capnography PETco2 measured via LMA or ETT correlate well with Paco2 during mechanical ventilation in children as well as in adults breathing spontaneously PETco2 measured via ET tube PETco2 measured via LMA During spontaneous ventilation in adults, the mean difference between Paco2 and PETco2 measured via LMA is similar to that measured via
- [Hypermetabolic states](https://www.capnography.com/hypermetabolic-states/) - Clinical Aspects Bhavani Shankar Kodali MD Hypermetabolic states Dangerous hypermetabolic conditions such as malignant hyperthermia, thyrotoxic crisis, and severe sepsis, can be detected by C02 monitoring. Increased metabolic rates cause greater C02 production, which can cause PETCO2 to increase. An increasing PETCO2 may, therefore, be an early warning sign of an impending hypermetabolic crisis.1 Cardiopulmonary
- [Venous C02 embolism](https://www.capnography.com/venous-c02-embolism/) - Clinical Aspects Bhavani Shankar Kodali MD Venous C02 embolism End-tidal C02 monitoring is essential during laparoscopy, as it may help in the early detection of venous C02 embolism (accidental insufflation of C02 into the veins). In addition, C02 is also absorbed from abdominal cavity. A transient but rapid rise in PETCO2, has been suggested as
- [Pulmonary thrombo-embolism](https://www.capnography.com/pulmonary-thrombo-embolism/) - Clinical Aspects Bhavani Shankar Kodali MD Pulmonary thrombo-embolism Pulmonary thrombo-embolism is also associated with a decrease in PETCO2 as is in pulmonary air embolism. Breen et al,1 in an animal study, found that PETCO2 decreases when right pulmonary artery (RPA) was occluded in anesthetized, ventilated, thoracotomized dogs. By 1 min after RPA occlusion, CO2 volume
- [Detection of pulmonary air embolism](https://www.capnography.com/detection-of-pulmonary-air-embolism/) - Clinical Aspects Bhavani Shankar Kodali MD Detection of pulmonary air embolism A rapid decrease of PETCO2 in the absence of changes in blood pressure, central venous pressure and heart rate indicates an air embolism without systemic hemodynamic consequences.1,2 However, as the size of air embolism increases, a reduction in cardiac output occurs which further decreases
- [Accidental esophageal intubation](https://www.capnography.com/accidental-esophageal-intubation/) - Clinical Aspects Bhavani Shankar Kodali MD Accidental esophageal intubation Tracheal intubation Esophageal intubation Capnograms during esophageal intubation Flat line - No CO2 Few Blips of CO2 from the upper airway and esophagus Esophageal intubation following a mask ventilation. Mask ventilation pushes alveolar gas into the esophagus and stomach DETAIL Ingestion of carbonated beverages prior to
- [Integrity of anesthetic apparatus](https://www.capnography.com/integrity-of-anesthetic-apparatus/) - The integrity of anesthetic apparatus Bhavani Shankar Kodali MD Anesthetic mishaps due to airway problems, leaks and disconnections in the anesthesia system often develop and may become apparent only when a crisis occurs. Circuit leaks which decrease the minute volume may not be indicated by airway pressure monitoring but may be detected by C02 monitoring
- [Adjustments of fresh gas flow rates (FGF) in rebreathing systems](https://www.capnography.com/adjustments-of-fresh-gas-flow-rates-fgf-in-rebreathing-systems/) - Adjustments of fresh gas flow rates (FGF) in rebreathing systems Bhavani Shankar Kodali MD The FGF’s required with various rebreathing systems during anesthesia can be adjusted precisely by continuous monitoring of PETCO2 and doing so prevents hypercarbia due to inadequate flow rates. References 1. Lenz G, Heipertz W, Epple E. Capnometry for continuous postoperative monitoring
- [Adequacy of spontaneous respiration](https://www.capnography.com/adequacy-of-spontaneous-respiration/) - ASA Standards of monitoring during anesthesia Bhavani Shankar Kodali MD Adequacy of spontaneous respiration Sampling of CO2 from oxygen mask Sampling of CO2 from nasal cannulae Capnography can be used to monitor the adequacy of spontaneous ventilation, not only during general anesthesia and recovery but also in the awake unintubated patient either in the intensive
- [Analysis of CO2 waveforms:    4](https://www.capnography.com/analysis-of-co2-waveforms-4/) - Clinical Aspects Bhavani Shankar Kodali MD Analysis of CO2 waveforms: Height of the plateau: Increases in metabolism raise the height of the plateau whereas decreases in metabolism, cardiac output and effective circulating blood volume reduce the height.1-8 The height of the plateau is also dependent on ventilation. Hyperventilation decreases it whereas hypoventilation can result
- [Analysis of CO2 waveforms:    3](https://www.capnography.com/analysis-of-co2-waveforms-3/) - Clinical Aspects Bhavani Shankar Kodali MD Analysis of CO2 waveforms: Descending limb: The descending limb can be prolonged or slanted, when the inspiratory valve of a closed circuit system is incompetent.1-3 or because of the use of side-stream sensor capnographs, with a prolonged response time.4 The capnograph with a prolonged response time also results
- [Analysis of CO2 waveforms:    2](https://www.capnography.com/analysis-of-co2-waveforms-2/) - Clinical Aspects Bhavani Shankar Kodali MD Analysis of CO2 waveforms: Prolongation phase II and III: Prolongation or slanting of the expiratory upstroke phase II occurs when there is obstruction to expiratory gas flow (e.g., asthma, bronchospasm, obstructive pulmonary disease, and kinked endotracheal tube,1-9 or in the presence of leaks in the breathing system.10 A
- [Analysis of CO2 waveforms:](https://www.capnography.com/analysis-of-co2-waveforms/) - Clinical Aspects Bhavani Shankar Kodali MD Analysis of CO2 waveforms: Elevated inspiratory base line: An elevated inspiratory base line and phase I indicates CO2 rebreathing, which is abnormal with circle breathing systems, and suggests either an exhausted C02 absorbent in circle system or incompetent valves.1-6 It is normally anticipated with the Bain anaesthetic system
- [Analysis of Capnograms](https://www.capnography.com/analysis-of-capnograms/) - Clinical Aspects Kodali. Bhavani Shankar MD How to analyze CO2 waveforms ? The shape of a capnogram is identical in all humans with healthy lungs. Any deviations in shape must be investigated to determine a physiological or a pathological cause of the abnormality Five characteristics of capnogram should be evaluated Frequency Rhythm Height Baseline Shape
- [From Lines and Curves--Shapes of capnograms - Capnography](https://www.capnography.com/from-lines-and-curves-shapes-of-capnograms-capnography/) - Clinical uses of capnography Bhavani Shankar Kodali MD Capnography is superior to capnometry for three reasons Confirming adequate sampling Capnography may be the only guide to detect the adequacy of gas sampling Normal Sampling leaks/dilution of expired gases Capnography may be the only guide to detect the adequacy of gas sampling from the airways, the
- [From Numbers- PETCO2 values- Capnometry](https://www.capnography.com/from-numbers-petco2-values-capnometry/) - Clinical uses of capnography Bhavani Shankar Kodali MD Capnometry Various factors result in either increased or decreased/absent PETCO2. PETCO2 increased output Pulmonary perfusion Alveolar Ventilation Technical errors Machine faults Fever Malignant hyperpyrexia Sodium bicarbonate Tourniquet release Venous CO2 embolism Increased cardiac output Increased blood pressure Hypoventilation Bronchial intubation Partial airway obstruction Rebreathing Exhausted CO2 absorber
- [Clinical Uses](https://www.capnography.com/clinical-uses/) - Clinical Aspects Bhavani Shankar Kodali MD Capnography provides three sources of information From Numbers- PETCO2 values- Capnometry From Lines and Curves--Shapes of capnograms - Capnography From (a-ET)PCO2 gradients or differences- Alveolar dead space Analysis of Capnograms Applications/Clinical uses of Capnography
- [Negative  (a-ET)PCO2  differences](https://www.capnography.com/negative-a-etpco2-differences/) - Physiology of capnography Bhavani Shankar Kodali MD Can Negative (a-ET)CO2 differences occur? Where can they occur? Healthy subjects during low frequency high tidal volume ventilation Pregnant subjects Infants and Children After coming off cardiac bypass During and after exercise. What are the reasons for negative values? Experimental errors Rebreathing Inadvertent addition of CO2 to the
- [(a-ET)CO2  difference and Alveolar dead space](https://www.capnography.com/a-etco2-difference-and-alveolar-dead-space/) - Physiology of capnography Bhavani Shankar Kodali MD (a-ET)PCO2 reflects Alveolar Dead Space (a-ET)PCO2 reflects alveolar dead space as a result of a temporal, a spatial and an alveolar mixing defect in the normal lung. Normal values of (a-ET)PCO2 is 2-5 mm Hg. (a-ET)PCO2 as an index of alveolar dead space There is a positive relationship
- [Phase IV](https://www.capnography.com/phase-iv/) - Physiology of capnography Bhavani Shankar Kodali MD Phase IV A terminal upswing at the end of phase III Occurs in obese patients and in pregnant subjects where thoracic compliance is reduced Etiology Slow alveoli empty out more evenly (expiratory flow rate is more constant) and the increase in PCO2 is spread more evenly over the
- [PETCO2  and Cardiac output](https://www.capnography.com/petco2-and-cardiac-output/) - Physiology of capnography Bhavani Shankar Kodali MD How does cardiac output affect PETCO2 Increases in cardiac output and pulmonary blood flow result in better perfusion of the alveoli and a rise in PETCO2. Under conditions of constant lung ventilation, PETCO2 monitoring can be used as a monitor of pulmonary blood flow Cardiac output and (a-ET)PCO2
- [Capnogram and Tidal volume](https://www.capnography.com/capnogram-and-tidal-volume/) - Physiology of capnography Bhavani Shankar Kodali MD How is a capnogram related to a tidal volume? * Area under the CO2 curve = Effective Alveolar ventilation * Area above the curve and below the PaCO2 = Physiological dead space Determination of components of tidal volume using a capnogram Physiological dead space sub-divided into anatomical dead
- [Volume Capnogram verses Time capnogram](https://www.capnography.com/volume-capnogram-verses-time-capnogram/) - Physiology of capnography Bhavani Shankar Kodali MD Volume Capnogram / Expirogram/ SBTCO2CO2 Curve Time Capnogram Time capnography is simple, popular and adequate for clinical use h6: There is no inspiratory segment in a volume capnogram The expiratory segment is divided into three phases Phase III of a volume capnogram is a better representation of
- [Components of a time capnogram](https://www.capnography.com/components-of-a-time-capnogram/) - Physiology of Capnography Bhavani Shankar Kodali MD Components of a time capnogram Inspiratory segment Expiratory segment Phase 0: Inspiration Beta Angle - Angle between phase III and descending limb of inspiratory segment. Phase I - Anatomical dead space Phase II - Mixture of anatomical and alveolar dead space Phase III - Alveolar plateau Alfa angle
- [Trend Capnogram](https://www.capnography.com/trend-capnogram/) - Physiology of Capnography Bhavani Shankar Kodali MD Fast or Regular Capnogram A Trend Capnogram A time capnogram may be recorded at two speeds. A high speed capnogram (about 7mm.sec-1) gives detailed information about each breath whereas the overall CO2 changes (trend) can be followed at a slow (about 0.7 mm.sec-1) speed.1 Reference: 1.Bhavani Shankar K,
- [Basic Physiology of a Capnogram](https://www.capnography.com/basic-physiology-of-a-capnogram/) - Physiology of capnography Bhavani Shankar Kodali MD Basic Physiology At the end of inspiration, assuming that there is no rebreathing, the airway and the lungs are filled with CO2-free gases. Carbon dioxide diffuses into the alveoli and equilibrates with the end-alveolar capillary blood (PACO2 = PcCO2 = 40 mm Hg). The actual concentration of CO2 in
- [Recent advances in technology](https://www.capnography.com/recent-advances-in-technology/) - Microstream technology for side-stream sensors. Main-stream sensors. Ultra-compact MicroRotor technology
- [Types of Capnographs](https://www.capnography.com/types-of-capnographs/) - Physics of Capnography Bhavani Shankar Kodali MD Types of Capnographs Main-stream Capnographs Side-stream Capnographs CO2 sensor located between endotracheal tube and breathing circuit Sensor is located in the main unit and CO2 is aspirated via a sampling tube connected to a T-piece adapter located endotracheal tube and breathing circuit. Side-stream Capnographs Advantages Disadvantages Easy to
- [Response Time of Analyzer](https://www.capnography.com/response-time-of-analyzer/) - Physics of Capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Slow analyzers distort CO2 wave forms 2008-07-29Response time (Components) What is it? Affect on CO2 Transit time Time to move from point of sampling to point of measurement Underestimation due to dispersion of gases at longer transit times Rise time (T70/T90) Time to change
- [Effect of Inhalational Agents](https://www.capnography.com/effect-of-inhalational-agents/) - Physics of capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Inhalational agents do not affect CO2 measurement The low concentrations of halogenated anaesthetic agents used during anaesthesia absorb IR energy at different wave lengths (around 3.3 milli microns) and their interference is not considered to be important.1 Reference: Carbon dioxide monitors. Health Devices;15:255-85.
- [Effect of water vapor](https://www.capnography.com/effect-of-water-vapor/) - Physics of Capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Water absorbs IR light but minimum at 4.3µ m How does water vapor affect CO2 readings? Water can condense on IR cell and interfere with CO2 measurements Decrease in partial pressure of water due to temperature differences between the patient's airway and the measuring
- [Effect of Oxygen](https://www.capnography.com/effect-of-oxygen/) - Physics of capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Oxygen does not absorb IR light Oxygen does have affect via collision broadening effect How does oxygen affect CO2 measurements? Oxygen does not absorb IR light Oxygen produces collision broadening phenomena that can cause falsely low CO2 measurements. Although oxygen does not absorb
- [Effect of Nitrous Oxide](https://www.capnography.com/effect-of-nitrous-oxide/) - Physics of Capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Nitrous oxide absorbs IR light. Absorption is minimal at IR 4.3 µ m Collision Broadening Phenomenon Effect of n2o on C02 measurements Use of 4.3 µ m IR light does not affect C02 measurements. Collision broadening phenomena does increase C02 values. Correction factors for
- [Effect of atmospheric pressure](https://www.capnography.com/effect-of-atmospheric-pressure/) - Physics of capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Effect of Atmospheric Pressure How does atmospheric pressure affect CO2? Increases in atmospheric pressure result in an increase in the PETCO2 values by increasing number of IR absorbing molecules and increasing intermolecular forces The effect of Atmospheric pressure can be minimized by:-
- [Factors Affecting IR Spectrography](https://www.capnography.com/factors-affecting-ir-spectrography-main/) - 1. Atmospheric Pressure 2. Nitrous Oxide 3. Oxygen 4. Water Vapor 5. Inhalational Agents 6. Response Time
- [Physical Method of CO2 Measurement](https://www.capnography.com/physical-method-of-co2-measurement-sp-292589181/) - Physics of Capnography Bhavani Shankar Kodali MD There are five Physical methods 1. Infra-red Spectrography 2. Molecular Correlation Spectrography 3. Raman Spectrography 4. Mass Spectrography 5. Photoacoustic Spectrography Infra Red Spectrography CO2 absorbs Infra red light at 4.3 µm Infra-red spectrographs are more compact and less expensive than the other methods of measurement. This
- [Terminology of capnograms](https://www.capnography.com/terminology-of-capnograms-2/) - Terminology of capnograms Bhavani Shankar Kodali MD Over the last two decades, time capnography has become a standard of monitoring in anesthesia practice in many countries. Along with the acceptance of this technology, however, there has also been a considerable proliferation of terminology representing the various components of a time capnogram. This ambiguity in terminology
- [ASA Standards of monitoring during anesthesia](https://www.capnography.com/asa-standards-of-monitoring-during-anesthesia/) - ASA Standards of monitoring during anesthesia Bhavani Shankar Kodali MD October ASA Standards of Care - Capnography in 1990s. Pulse oximetry in 1989 followed by capnography. 1999 - Included capnography for mask anesthesia Standard for "every patient receiving general anesthesia Continual monitoring for the presence of expired carbon dioxide Identification of expired CO2 to verify
- [Mumbai 2008 NEMAACON](https://www.capnography.com/mumbai-2008-nemaacon/) - Northeastern Mumbai Assoication of Anesthesiologists Conference 2008, Mumbai Delivering the key note lecture: "What is new in anesthesiology that could impact our practice in near future"
- [Guntur Medical College, Visiting Professor](https://www.capnography.com/guntur-medical-college-visiting-professor/) - Visiting Professor to Guntur Medical College 'Capnography in Clinical Practice Lecture"
- [Nizam's Institute of Medical Sciences, Hyderabad, 2007](https://www.capnography.com/nizams-institute-of-medical-sciences-hyderabad-2007/) - Mission: "Obstetric Analgesia". Visiting Professor July 14th, 2007 Recent concepts in Obstetric Analgesia Nizam's Institute of Medical Sciences, Hyderabad, India Professor Gopinath MD
- [NEMACON- Mumbai 2006](https://www.capnography.com/nemacon-mumbai-2006/) - Mission: "Exposing the hidden clinical science within the carbon dioxide waveforms to enhance the safety of patients during anesthesia". Pictures from recent visiting professor assignment - Mumbai 2006 Opening ceremony Opening remarks Delivering the 'Oration Lecture' Audience Falicitating Professor Kangle FFARCS (My former Professor at Jipmer) and currently practicing in Mumbai Also seen are Professor
- [Christian Medical College - Vellore 2007india](https://www.capnography.com/christian-medical-college-vellore-2007india/) - Mission: "Exposing the hidden clinical science within the carbon dioxide waveforms to enhance the safety of patients during anesthesia". Visiting Professor July 7th, 2007 10 AM to 5 PM AM session: Capnography PM session: Obstetric Analgesia Christian Medical College, Vellore, India Professor Rebecca Jacobs MD CMC Campus CMC Campus CMC Campus
- [Medical Simulation](https://www.capnography.com/medical-simulation/) - I have developed a substantial interest in medical simulation. I see simulation as the method for teaching the values of respect and teamwork. It has been about 40 years since I joined anesthesiology. During these four decades, travelling through five countries, I observed the same deficiencies in each workplace irrespective of resource level, high or low. There
- [ASA Prize for Bhavani Kodali](https://www.capnography.com/asa-prize-for-bhavani-kodali/) - Bhavani Shankar Kodali along with Michael D'Ambra recieves ASA third prize for Scientific Exhibit in New Orleans ASA meeting 2009. Seen in the picture are Roger A. Moore MD (ASA President) and Andrew Rosenberg MD Once again, Third Prize In 2011 at ASA : Why do Labor Epidurals Fail: 3D Understanding
- [Bhavani Shankar Kodali MD - Distinguished Clinician Award - Brigham and Women's Hospital](https://www.capnography.com/bhavani-shankar-kodali-md-distinguished-clinician-award-brigham-and-women-s-hospital/)
- [Arterial to end-tidal carbon dioxide difference in children undergoing mechanical ventilation of the lungs during general anaesthesia](https://www.capnography.com/arterial-to-end-tidal-carbon-dioxide-difference-in-children-undergoing-mechanical-ventilation-of-the-lungs-during-general-anaesthesia/) - Arterial to end-tidal carbon dioxide difference in children undergoing mechanical ventilation of the lungs during general anaesthesia. Onodi C, Bühler PK, Thomas J, Schmitz A, Weiss M. Anaesthesia. 2017 Jul 11. doi: 10.1111/anae.13969. [Epub ahead of print] The abstract is as follows: The authors state that capnography (ETCO2 ) is routinely used as a non-invasive estimate of
- [Kuwait Oil Company Visiting Professor](https://www.capnography.com/kuwait-oil-company/) - Back to Visiting Professor lectures
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- [Qatar Health, Doha, Qatar](https://www.capnography.com/qatar-health-doha-qatar/) - Back to Visiting Professor lectures
- [Ramachandra University Professorship](https://www.capnography.com/ramachandra-university-proffessorship/) - ` Back to Visiting Professor lectures
- [Effect of Inhalational Agents](https://www.capnography.com/effect-of-inhalational-agents-2/) - Physics of capnography Bhavani Shankar Kodali MD Factors affecting IR Spectrography Effect of Inhalational agents Inhalational agents do not affect CO2 measurement The low concentrations of halogenated anaesthetic agents used during anaesthesia absorb IR energy at different wave lengths (around 3.3 milli microns) and their interference is not considered to be important.1
- [(a-ET)CO2  difference and Alveolar dead space](https://www.capnography.com/a-etco2-difference-and-alveolar-dead-space-2/) - Physiology of capnography Bhavani Shankar Kodali MD (a-ET)PCO2 reflects Alveolar Dead Space (a-ET)PCO2 reflects alveolar dead space as a result of a temporal, a spatial and an alveolar mixing defect in the normal lung. /p: Normal values of (a-ET)PCO2 is 2-5 mm Hg. (a-ET)PCO2 as an index of alveolar dead spaceThere is a positive
- [Capnography and Laparoscopy](https://www.capnography.com/capnography-and-laparoscopy-2/) - Capnography and Laparoscopy Bhavani Shankar Kodali MD Capnography has three important applications during laparoscopic surgery. 1. It serves as a non-invasive monitor of PaCO2 during CO2 insufflation and therefore can be used to adjust ventilation.2. It may help in the detection of accidental intravascular CO2 insufflation.3. It may help in the detection of
- [Dual waveform capnogram](https://www.capnography.com/dual-waveform-capnogram-2/) - Dual waveform capnogram This capnogram occurs due to sampling leaks in the sampling tube cracks, or a loose connection between sampling tubes and the monitor. It has also been reported due to breaks in the water filter of the carbon dioxide analyzer. (Provided by Simon Body and James Philips) This shape of a capnogram
- [Capnography as a non invasive-monitor of PaCO2 during thoracic anesthesia](https://www.capnography.com/capnography-as-a-non-invasive-monitor-of-paco2-during-thoracic-anesthesia/) - Capnography during thoracic anesthesia Bhavani Shankar Kodali MD Capnography as a non invasive-monitor of PaCO2 during thoracic anesthesia The arterial to end-tidal PCO2 difference is dependent on the underlying pulmonary disease. The most common reason for thoracotomy in adults is surgical treatment of lung cancer. Patients with lung cancer are almost exclusively smokers, and
- [Terminology of capnograms](https://www.capnography.com/terminology-of-capnograms-3/) - Terminology of capnograms Bhavani Shankar Kodali MD Over the last two decades, time capnography has become a standard of monitoring in anesthesia practice in many countries. Along with the acceptance of this technology, however, there has also been a considerable proliferation of terminology representing the various components of a time capnogram. This ambiguity in terminology
- [Cardiac output and PETCO2](https://www.capnography.com/cardiac-output-and-petco2-2/) - During steady-state gas exchange equilibrium, the alveolar PCO2 (PACO2), tissue CO2 production (VCO2), and alveolar ventilation (VA) are related as given by the following equation: PACO2 = (K)VCO2/VA During constant ventilation and CO2 production, an abrupt reduction in cardiac output (Qt) reduces PECO2.1-7 This may occur because of two mechanisms.1,2
- [What happens to PETCO2 when there is pneumothorax?](https://www.capnography.com/what-happens-to-petco2-when-there-is-pneumothorax-2/) - I have been asked this question by several colleagues. The answer, however, is not simple. It depends on the status of a pneumothorax (evolution), cause of pneumothorax, and the content of the pneumothorax (air/oxygen/nitrous oxide versus carbon dioxide). Pneumothorax can affect the PETCO2 as well as the shape of the capnograms. If
- [Capnography During Sedation](https://www.capnography.com/capnography-during-sedation/) - Capnography During Sedation Venkatesh Srinivasa MD & Bhavani Shankar Kodali MD Capnography is vital during sedation Concerns during sedation How to monitor ventilation? Capnograms during sedation Capnography in Veterinary sedation
- [r true 2](https://www.capnography.com/r-true-2/) - Not Found The requested URL /Capnoclips/Sorry, you are wrong was not found on this server.
- [Endobronchial intubation 1](https://www.capnography.com/endobronchial-intubation-1/) - Endobronchial IntubationThe characteristic features of capnogram in endobronchial intubation are dependent on the extent of endobronchial intubation. The ETCO2 can increase if the consequent one lung ventilation results in hypoventilation. On the other hand, if the tube is far down resulting in over all reduced ventilation (small tidal volumes), then ETCO2 can decrease (not adequate
- [Emergency Medicine and Prehospital Critical Care](https://www.capnography.com/emergency-medicine-and-prehospital-critical-care/) - Use of Capnography in Emergency Medicine and Prehospital Critical Care Samuel M. Galvagno Jr., D.O. Bhavani shankar Kodali MD Samuel M. Galvagno Jr., D.O. Chief Resident, Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Woman’s Hospital, Harvard Medical School, Boston, MA The measurement of carbon dioxide (CO2) in expired air directly indicates changes in
- [Dual Plateau capnogram caused by cracked sample filter](https://www.capnography.com/dual-plateau-capnogram-caused-by-cracked-sample-filter/) - Dual Plateau capnogram caused by cracked sample filter A dual plateau capnogram was observed by Body et al during anesthesia and IPPV. They found that the cause of the abnormality was due a microscopic crack in the filter membrane separator cartridge of the Ohmeda RGM 5250 gas analyzer. The authors hypothesized that, during the
- [Physical Method of CO2 Measurement](https://www.capnography.com/physical-method-of-co2-measurement/) - 1.Infra Red Spectrography 2.Molecular Correlation Spectrography (Microstream technology) 3.Mass Spectrography 4.Raman Spectrography 5.Photoacoustic Spectrography Main
- [Carbon dioxide Embolism](https://www.capnography.com/carbon-dioxide-embolism-2/) - Venous CO2embolism End-tidal CO2 monitoring is essential during laparoscopy, as it may help in the early detection of venous CO2 embolism (accidental insufflation of CO2 into the veins). In addition, CO2 is also absorbed from abdominal cavity. A transient but rapid rise in PETCO2, has been suggested as a useful early sign of venous CO2
- [Physics of capnography](https://www.capnography.com/physics-of-capnography/) - Physical Methods of Carbon dioxide Measurement Infra Red Spectrography Molecular Correlation Spectrography (Microstream technology) Mass Spectrography Raman Spectrography Photoacoustic Spectrography Factors Affecting IR Spectrography Atmospheric Pressure Nitrous Oxide Oxygen Water Vapor Inhalational Agents Response Time Chemical Method of Carbon dioxide Measurement Types of Capnographs Main-stream Capnographs Side-stream Capnographs Recent advances in
- [Infra Red Spectrography](https://www.capnography.com/infra-red-spectrography/) - Infra Red Spectrography CO2 absorbs Infra red light at 4.3 µm Infra-red spectrographs are more compact and less expensive than the other methods of measurement. This has been the most popular technique for monitoring C02. The wavelength of IR rays exceeds 1.0 milli micron while the visible spectrum is between 0.4 and 0.8 milli
- [Molecular Correlation Spectrography (MCS)](https://www.capnography.com/molecular-correlation-spectrography-mcs/) - Molecular Correlation Spectrography (MCS) Microstream technology is built on unique approach to IR radiation emission. Laser-based technology, i.e., molecular correlation spectroscopy (MCS), is used to generate an IR emission that precisely matches the absorption spectrum of CO2 molecule. The high emission efficiency and extreme CO2 specificity and sensitivity of the emitter-detector combination allows for
- [Raman Spectrography](https://www.capnography.com/raman-spectrography/) - Raman Spectrography Raman Spectrography uses the principle of "Raman Scattering" for CO2 measurement. The gas sample is aspirated into an analyzing chamber, where the sample is illuminated by a high intensity monochromatic argon laser beam. The light is absorbed by molecules which are then excited to unstable vibrational or rotational energy states (Raman scattering).
- [Mass Spectrography](https://www.capnography.com/mass-spectrography/) - Mass Spectrography The mass spectrograph separates molecules on the basis of mass to charge ratios. A gas sample is aspirated into a high vacuum chamber (10-5 mmHg) where an electron beam ionizes and fragments the components of the sample. The ions are accelerated by an electric field into a final chamber, which
- [Physiology of Capnography](https://www.capnography.com/physiology-of-capnography/) - Basic Physiology of a Capnogram Trend Capnogram Components of a Time Capnogram Volume Capnogram 'verses' Time capnogram Capnogram and Tidal volume PETCO2 and Cardiac output Phase IV (a-ET)CO2 difference and Alveolar dead space Negative (a-ET)PCO2 differences
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- [Egypt Meetings 2016, 2017](https://www.capnography.com/egypt-meetings-2016-2017/)
- [SOAP Meeting at Monterey, California](https://www.capnography.com/soap-meeting-at-monterey-california/)
- [Assessment of Bohr and Enghoff Dead Space Equations in Mechanically Ventilated Children.](https://www.capnography.com/assessment-of-bohr-and-enghoff-dead-space-equations-in-mechanically-ventilated-children/) - Assessment of Bohr and Enghoff Dead Space Equations in Mechanically Ventilated Children. Bourgoin P, Baudin F, Brossier D, Emeriaud G, Wysocki M, Jouvet P. Respir Care. 2017 Apr;62(4):468-474 Recent findings suggest that using alveolar PCO2 (PACO2 ) estimated by volumetric capnography in the Bohr equation instead of PaCO2 (Enghoff modification) could be appropriate for the calculation of physiological dead
- [Oral capnography is more effective than nasal capnography during sedative upper gastrointestinal endoscopy.](https://www.capnography.com/oral-capnography-is-more-effective-than-nasal-capnography-during-sedative-upper-gastrointestinal-endoscopy/) - Oral capnography is more effective than nasal capnography during sedative upper gastrointestinal endoscopy. Teng WN, Ting CK, Wang YT, Hou MC, Tsou MY, Chiang H, Lin CL. J Clin Monit Comput. 2017 May 24. doi: 10.1007/s10877-017-0029-8. [Epub ahead of print The authors evaluated the role of capnography in esophagogastroduodenoscopy (EGD). Simultaneous supplemental oxygen, position of patient, open mouth breathing pattern,
- [Sudden Increase in EtCO2 During Upper Endoscopy Under General Endotracheal Anesthesia Suggests the Presence of Tracheoesophageal Fistula: A Case Report](https://www.capnography.com/sudden-increase-in-etco2-during-upper-endoscopy-under-general-endotracheal-anesthesia-suggests-the-presence-of-tracheoesophageal-fistula-a-case-report/) - Sudden Increase in EtCO2 During Upper Endoscopy Under General Endotracheal Anesthesia Suggests the Presence of Tracheoesophageal Fistula: A Case Report. Garcia Getting RE, Harris CL. A A Case Rep. 2017 Aug 15;9(4):109-111 The authors reported a case where they were able to diagnose tracheoesophageal fistula in a patient with lung cancer status post palliative chemoradiotherapy and esophageal
- [Patient safety during procedural sedation using capnography monitoring: a systematic review and meta-analysis](https://www.capnography.com/patient-safety-during-procedural-sedation-using-capnography-monitoring-a-systematic-review-and-meta-analysis/) - Patient safety during procedural sedation using capnography monitoring: a systematic review and meta-analysis. Saunders R, Struys MMRF, Pollock RF, Mestek M, Lightdale JR. BMJ Open. 2017 Jun 30;7(6):e013402. doi: 10.1136/bmjopen-2016-013402. The objective of this study was to evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to
- [Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue](https://www.capnography.com/continuous-capnography-reduces-the-incidence-of-opioid-induced-respiratory-rescue/) - Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue Stites M, Surprise J, McNiel J, Northrop D, De Ruyter M. J Patient Saf. 2017 Jul 20. doi: 10.1097/PTS.0000000000000408 This is retrospective sentinal study. The authors determined the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory
- [Capnography can predict survival among trauma victims.](https://www.capnography.com/capnography-can-predict-survival-among-trauma-victims/) - In a series, the authors found that low end-tidal carbon dioxide (PETCO2) at the onset of trauma is associated with nonsurvival (Roman et al, Anesthesia & Analgesia 2017, July 10). This is a retrospective study of patients admitted and transferred to the operating room directly from the resuscitation bay. The patients were identified using the
- [Where is Capnography Heading?](https://www.capnography.com/where-is-capnography-heading/) - Capnography Outside The Operating Rooms In recent years, capnography's value in enhancing patient safety has been recognized by those physicians providing clinical care outside of operating rooms. Clinical departments are pursuing capnography implementation in their domains. However, mandatory training for the interpretation of capnography relevant to the clinical provider's practice is required. This website
- [Checking Capnograph before clinical use](https://www.capnography.com/checking-capnograph-before-clinical-use/) - Checking or test capnograph before clinical use One should ascertain that the capnograph is functioning properly before making any interpretations of PETCO2 readings and waveforms. Secretions and mucus may contaminate the unit, and distort CO2 waveforms. Similarly, water may partially obstruct sampling lines resulting in distorted waveforms. A leak in the sampling tube may result
- [Capnography - Monitoring Patients Receiving Narcotics for Postoperative Pain Control](https://www.capnography.com/capnography-monitoring-patients-receiving-narcotics-for-postoperative-pain-control/) - These lecture presentations were a part of Webinar on "Safe opioid use - Strategies for reducing adverse events and related harm " (March 4th, 2014) moderated by Gina Pugliese, RN MS FSHEAVice President, Premier Safety Institute®Phone/fax: 704.816.5874Cellular: 708.203.5013 Our Experience in Successfully using ETCO2 Monitoring During the Usage of PCA Pain Management Harold
- [Capnography Lecture Powerpoint - Bhavani Shankar Kodali MD](https://www.capnography.com/capnography-lecture-powerpoint-bhavani-shankar-kodali-md/) - You can view this comprehensive PowerPoint presentation on capnography Capnography PowerPoint Presentation
- [Capnography outside the operating rooms - New 2013](https://www.capnography.com/new-2013/) - This is an educational article published in Anesthesiology January 2013 written by me on "Capnography outside the operating rooms". This is published under the section of Clinical Concepts Commentary and highlights the current and future role of capnography outside the operating rooms. This is a free article from the January issue of Anesthesiology 2013
- [Capnography Everywhere](https://www.capnography.com/capnography-everywhere/) - The following presentation is provided by Dr David K Whitaker FFARCS. This theme of this lecture presentation is based on his editorial 'Capnography Everywhere' in Anaesthesia 2011;6:544-9. Pdf presentation of the lecture given at Difficult Airway Society Meeting at Nottingham 2011. Pdf presentation of "Capnography - the future: You know it makes sense:
- [NPR news and capnography](https://www.capnography.com/npr-news-and-capnography/) - October 3, 2011 Donate | NPR Shop | NPR Social Media | Login | Register Morning Edition[4 min 37 sec] Enlarge May Clinic Howard Snitzer's heart stopped beating for 96 minutes last January. First responders didn't give up on him, thanks in part to capnography, a technology that let them know Snitzer still had a
- [Time for capnography - Everywhere](https://www.capnography.com/time-for-capnography-everywhere/) - Time for capnography - everywhereThis title is based on the editorial by DR Whitaker in Anaesthesia 2011;66:544-9 titled "Time for Capnography - Everywhere" Anesthesiologists have adopted capnography as a standard of monitoring in operating rooms for 25 years. Despite proven value of capnography in operating rooms, its use in outside of the operating rooms has not matched
- [CPR and Capnography](https://www.capnography.com/cpr/) - Since the current guidelines of ACLS, and AAGBI recommend capnography during CPR, we have adapted the following. The movable stand is equipped with code box, capnograph, and a Video laryngoscope for unanticipated difficult intubation when called for a code
- [AAGBI Safety Statement on Capnography](https://www.capnography.com/aagbi-safety-statement-on-capnography/) - This is reproduced from the Association of Anaesthetists of Great Britain and Ireland AAGBI SAFETY STATEMENT The use of capnography outside the operating theatre Updated statement from the Association of Anaesthetists of Great Britain & Ireland (AAGBI) May 2011 The AAGBI publications ‘Recommendations for standards of monitoring during anaesthesia and recovery’ (4 th edition) 2007 (1) and ‘Capnography outside the operating room’ 2009 (2)
- [ACLS - New Guidelines](https://www.capnography.com/acls-new-guidelines/) - ACLS New Guidelines for 2011 and Capnography The new ACLS guidelines recommend the use of quantitative waveform capnography for confirmation and monitoring of endotracheal tube placement. The continuous measurement provides the partial pressure of carbon dioxide in mm Hg over time. Individuals requiring endotracheal intubation are at risk of tube displacement during transport and transfer and the
- [ICU, ED, PACU - Capnography](https://www.capnography.com/airway-management-data/) - The role of capnography in ICU and Emergency DepartmentJuly Issue of Anaesthesia has an editorial titled "Time for capnography everywhere". This is a must read article summarizing the value of capnography outside of operating rooms. It is 66 times more likely to have airway related deaths in ICU because of not using capnography routinely, unlike
- [Canography in Intensive Care Unit](https://www.capnography.com/canography-in-intensive-care-unit/) - Samuel M. Galvagno Jr., D.O.Bhavani Shankar Kodali, M.D. The value of Capnography is very well appreciated in the operating rooms and anesthesiologists have been well trained to rely on this valuable source of information in decision making. However, when the patient arrives into the intensive care unit (ICU), the patient is deprived of the benefits
- [What is new in capnography for 2010](https://www.capnography.com/what-is-new-in-capnography/) - Abstracts of recently published papers in 2010 The diagnostic role of capnography in pulmonary embolism.Kurt OK, Alpar S, Sipit T, et al. Am J Emerg Med 2010, May, 28(4):460-5.The authors evaluated the diagnostic contribution of alveolar dead space fraction (AVDSf) measured using capnography in patients admitted with suspected pulmonary embolism (PE). A total of 58 patients who were
- [Miniaturised Mainstream Multiple Anesthetic Gas Monitor](https://www.capnography.com/miniaturised-mainstream-multiple-anesthetic-gas-monitor/) - The Journal of Clinical Monitoring and Computing (2009;23(6)355-61) published performance of a miniaturized mainstream multigas monitor (MSGM). This unit uses infrared technique for measurements of carbon dioxide, nitrous oxide, and inhalation agents and fuel cell technique for oxygen monitoring. The performance of this analyzer was compared to side-stream monitor(Datex-Ohmeda S/5® in a bench study. The response
- [Postoperative Monitoring](https://www.capnography.com/postoperative-monitoring/) - Monitoring patients during the postoperative period 'Avoid near misses' Bhavani Shankar Kodali MD With the emphasis on treating postoperative pain aggressively, there is a substantial concern of narcotic-induced respiratory depression resulting in hypoxia in the immediate postoperative period. This is the time to think about this important phase of patient care. Intraoperative monitoring
- [Mapleson 'A' system](https://www.capnography.com/mapleson-a-system/) - Mapleson 'A' system M Ravi Shankar MD Professor and Chair of Anesthesia, JIPMER, Pondicherry, India Bhavani Shankar Kodali MDAssociatet ProfessorBrigham and Women's Hospital, Harvard Medical School Spontaneous ventilation - Most efficient Effect of FGF on capnogram. Rebreathing increases with FGF < alveolar ventilation Controlled ventilation - Least efficient Effect of FGF on capnogram. Rebreathing
- [Capnography on a CD](https://www.capnography.com/capnography-on-a-cd/) - The book edition of entire website including all pictures and graphic animations is available on a CD. It is in html format. A great teaching and learning tool ! Capnography - Flies into every operating room and every sedation area aruound the globe to ensure patient safety Pricing: Individual (Shipping within United States): US
- [increased phase III](https://www.capnography.com/increased-phase-iii/) - BronchospasmThe slope of the phase III is increased and phase II is prolonged. After the treatment, there is normalization of the capnogram. A similar picture results in children when a side stream analyzer with a longer response time is used.
- [hyper metabolic status](https://www.capnography.com/hyper-metabolic-status/)
- [Can you identify?](https://www.capnography.com/can-you-identify/) - There is downward flip on the plateau. This capnogram was recorded when the inspiratory valve of circle system was not falling back completely into the seat, thereby resulting in partial rebreathing. Red indicates the inspiratory portion of the capnogram.
- [What happens to PETCO2 when there is pneumothorax?](https://www.capnography.com/what-happens-to-petco2-when-there-is-pneumothorax/) - What happens to PETCO2 when there is pneumothorax? I have been asked this question by several colleagues. The answer, however, is not simple. It depends on the status of a pneumothorax (evolution), cause of pneumothorax, and the content of the pneumothorax (air/oxygen/nitrous oxide versus carbon dioxide). Pneumothorax can affect the PETCO2 as well as the
- [Cardiac output and PETCO2](https://www.capnography.com/cardiac-output-and-petco2/) - Cardiac output and PETCO2 During steady-state gas exchange equilibrium, the alveolar PCO2 (PACO2), tissue CO2 production (VCO2), and alveolar ventilation (VA) are related as given by the following equation: PACO2 = (K)VCO2/VA During constant ventilation and CO2 production, an abrupt reduction in cardiac output (Qt) reduces PECO2.1-7 This may occur because of two mechanisms.1,2 (1)
- [Capnography and Aortic 'x' clamping](https://www.capnography.com/capnography-and-aortic-x-clamping/) - Bhavani Shankar Kodali MDValue of capnography during major vascular surgery It has been well explained in this website that end tidal carbon dioxide values (ETCO2) has a very strong relationship to cardiac output. In my opinion, the value of this relationship is grossly underestimated in clinical practice. For a given ventilation, abrupt decreases in ETCO2
- [Capnography-tour includes](https://www.capnography.com/capnography-tour-includes/) - Capnography lecture tour Bhavani Shankar Kodali MD'Capnography-tour includes' Role of capnography Physics Physiology Clinical applications Capno-magic screen Capno-tips Limitations Dual capnography Conclusion Click here to begin the tour or on the section of your choice
- [capno-animation lecture tour](https://www.capnography.com/capno-animation-lecture-tour/) - Capnography lecture tour Bhavani Shankar Kodali MD This is the lecture format I use for giving grand rounds. If you borrow any material from this section for the purposes of teaching capnography, you may do so by acknowledging the source (www.capnography.com).If you present this material at conferences, please seek prior permission from the author via email.
- [rebreathing](https://www.capnography.com/rebreathing/) - The case report on "Failure To Detect CO2-absorbent Exaustion: Seeing and Believing" by Pond et al is an interesting reading.1 However, the interpretation of the abnormal capnogram as obtained by the authors (figure above) warrants further analysis.First of all, the differential diagnosis of the abnormal capnogram could be a curare cleft capnogram (if the second
- [Phase 4](https://www.capnography.com/phase-4/) - The terminal upswing towards the end of expiratory plateau. This occurs in pregnant patients and also in obese patients during anesthesia and IPPV.
- [Curare cleft](https://www.capnography.com/curare-cleft/) - Curare cleft Bhavani Shankar Kodali MDCurare Cleft as a result of partial disconnection of main stream CO2 sensorTripathi et al reported that a partial disconnect of a main stream capnometer also can present a "cleft" on the expiratory plateau during controlled ventilation.After induction of anesthesia, they noticed a "cleft" ( a sudden dip in CO2)
- [capnography at ASA](https://www.capnography.com/capnography-at-asa/) - A search of ASA abstracts related to capnography can be performed at the ASA link provided below ASA LINK (opens a new window, close the window to return) For a list of compiled abstracts on this website: 2000-2002 For al list of compiled abstracts on this website: 2003-2004
- [ANAESTHETIC BREATHING SYSTEMS](https://www.capnography.com/anaesthetic-breathing-systems/) - ANAESTHETIC BREATHING SYSTEMS DR M Ravi Shankar Professor and chair of Anesthesia JIPMER, Pondicheryy, India Introduction Since the introduction of diethyl ether as an anaesthetic in 1846, the speciality of anaesthesia has come a long way. In the initial phase, the attention was mainly diverted to administering a single agent and apparatus were developed to
- [ANAESTHETIC BREATHING SYSTEMS](https://www.capnography.com/anaesthetic-breathing-systems-2/) - ANAESTHETIC BREATHING SYSTEMS DR M Ravi Shankar Professor and chair of Anesthesia JIPMER, Pondicheryy, India Introduction Since the introduction of diethyl ether as an anaesthetic in 1846, the speciality of anaesthesia has come a long way. In the initial phase, the attention was mainly diverted to administering a single agent and apparatus were developed to
- [Non rebreathing system](https://www.capnography.com/non-rebreathing-system/) - Non rebreathing systemM Ravi Shankar MD Bhavani Shankar Kodali MDProfessor and Chair of Anesthesia, Associate ProfessorJIPMER, Pondicherry, India Harvard Medical SchoolFunctional analysisFGF should be equal to the minute ventilation of the patientFunctional analysis: When the patient takes a breath, or if the reservoir bag is squeezed, the inspiratory unidirectional valve opens and the gases
- [Non rebreathing system](https://www.capnography.com/non-rebreathing-system-2/) - Non rebreathing systemM Ravi Shankar MD Bhavani Shankar Kodali MDProfessor and Chair of Anesthesia, Associate ProfessorJIPMER, Pondicherry, India Harvard Medical SchoolFunctional analysisFGF should be equal to the minute ventilation of the patientFunctional analysis: When the patient takes a breath, or if the reservoir bag is squeezed, the inspiratory unidirectional valve opens and the gases flow
- [Bain breathing system](https://www.capnography.com/bain-breathing-system/) - Bain breathing systemM Ravi Shankar MD Bhavani Shankar Kodali MDProfessor and Chair of Anesthesia, Assistant ProfessorJIPMER, Pondicherry, India Brigham and Women's Hospital, Harvard Medical SchoolFunctional analysisEffect of FGF on capnogramControlled ventilation: Vt= 12ml/kg, f=12/min, FGF 70 ml/kg/min for normocarbia, FGF 100 ml/kg/min for hypocarbia. A lower FGF increases rebreathing fraction which results in the elevation
- [Bain breathing system](https://www.capnography.com/bain-breathing-system-2/) - Bain breathing systemM Ravi Shankar MD Bhavani Shankar Kodali MDProfessor and Chair of Anesthesia, Assistant ProfessorJIPMER, Pondicherry, India Brigham and Women's Hospital, Harvard Medical SchoolFunctional analysisEffect of FGF on capnogramControlled ventilation: Vt= 12ml/kg, f=12/min, FGF 70 ml/kg/min for normocarbia, FGF 100 ml/kg/min for hypocarbia. A lower FGF increases rebreathing fraction which results in the elevation
- [Circle breathing system](https://www.capnography.com/circle-breathing-system/) - Circle breathing systemM Ravi Shankar MD Bhavani Shankar Kodali MDProfessor and Chair of Anesthesia,Associate ProfessorJIPMER, Pondicherry, IndiaBrigham and Women's Hospital, Harvard Medical SchoolFunctional analysisEffect of FGF on capnogramRebreathing capnograms are due toExhausted soda limeInspiratory valve malfunctionExpiratory valve malfunctionThe essential components of the circle system are, (1) a sodalime canister, (2) Two unidirectional valves, (3) Fresh
- [Circle breathing system](https://www.capnography.com/circle-breathing-system-2/) - Circle breathing systemM Ravi Shankar MD Bhavani Shankar Kodali MDProfessor and Chair of Anesthesia,Associate ProfessorJIPMER, Pondicherry, IndiaBrigham and Women's Hospital, Harvard Medical SchooFunctional analysisEffect of FGF on capnogramRebreathing capnograms are due toExhausted soda limeInspiratory valve malfunctionExpiratory valve malfunctionThe essential components of the circle system are, (1) a sodalime canister, (2) Two unidirectional valves, (3) Fresh
- [Anesthesia breathing circuits](https://www.capnography.com/anesthesia-breathing-circuits/) - Table of contents IntroductionDefinitionRequirements of a Breathing SystemClassification (Table 1)Breathing systems without co2 absorptionUnidirectional FlowBidirectional FlowSubclassificationAfferent reservoir systemMagill systemEnclosed afferent reservoir systemEfferent reservoir systemBain systemCombined systemBreathing systems with co2 absorptionCircle systemTotally closed systemReferences INTRODUCTION Since the introduction of diethyl ether as an anaesthetic in 1846, the speciality of anaesthesia has come a long way. In
- [Anesthesia breathing circuits](https://www.capnography.com/anesthesia-breathing-circuits-2/) - Table of contents IntroductionDefinitionRequirements of a Breathing SystemClassification (Table 1)Breathing systems without co2 absorptionUnidirectional FlowBidirectional FlowSubclassificationAfferent reservoir systemMagill systemEnclosed afferent reservoir systemEfferent reservoir systemBain systemCombined systemBreathing systems with co2 absorptionCircle systemTotally closed systemReferences INTRODUCTION Since the introduction of diethyl ether as an anaesthetic in 1846, the speciality of anaesthesia has come a long way. In
- [ASA conference main page](https://www.capnography.com/asa-conference-main-page/) - A search of ASA abstracts related to capnography can be performed at the ASA link provided belowASA LINK (opens a new window, close the window to return) For a list of compiled abstracts on this website: 2000-2002For al list of compiled abstracts on this website: 2003-2004
- [2003-2004](https://www.capnography.com/2003-2004/) - ASA abstracts 2003-2004 Record 1 Year: 2003 Abstract Number: A-564 Score: 100 Title: Evaluation for New Main-Stream Capnography with Sedativenon-Intubated Volunteers in Comparison with Side-Stream Capnography Authors(s): Nobutada Morioka, M.D., Shinji Yamamori, , Mitsuhiro Narushima, M.D., Chisato Nozaki, M.D., Makoto Ozaki, M.D., Ph.D. Topic: EQUIPMENT, MONITORING, and ENGINEERING TECHNOLOGY View Files: •
- [Pitfalls of time capnography](https://www.capnography.com/pitfalls-of-time-capnography/) - Pitfalls of time capnography Bhavani Shankar Kodali MD Time capnography is a convenient method, commonly used in anesthetic practice to monitor ventilation. There are, however, subtle but important limitations of this process.11. The V/Q status of the lung is more accurately reflected in the slope of phase III in an SBT CO2 trace (volume capnogram)
- [In literature](https://www.capnography.com/in-literature/) - New applications of capnography Capnography versus bronchoscope during percutaneous tracheostomy A prospective randomized controlled trial of capnography vs. bronchoscopy for Blue Rhino percutaneous tracheostomy.Mallick A, Venkatanath D, Elliot SC, Hollins T, Nanda Kumar CG. A prospective randomized controlled trial of capnography vs. bronchoscopy for Blue Rhino percutaneous tracheostomy. Anaesthesia. 2003 Sep; 58(9): 864-8. A crucial
- [American Society of Anesthesiologist's Conference 2002/2001](https://www.capnography.com/american-society-of-anesthesiologists-conference-20022001/) - ASA 2000-2002 conferenceWeb based teaching www.capnography.com Presented as technical exhibit from Oct 14 noon to Oct 16,2001 noon at exhibit hall.Web based teaching www.capnography.com Presented as technical exhibit from Oct 14 noon to Oct 16,2001 noon at exhibit hall. Other presentations related to capnographyCapnographic Variations Produced by Leaks in Side-Stream Sampling Tubes: A Study Using
- [Non invasive measurement / monitoring of cardiac output:](https://www.capnography.com/non-invasive-measurement-monitoring-of-cardiac-output/) - New Technology In CapnographyKodali. Bhavani Shankar MDNon invasive measurement / monitoring of cardiac output:Recently, based on the well-known accepted Fick's Principle, Novametrix introduced NICO (Novametrix NICO®) cardiac output measurement device that uses partial co2 breathing to determine cardiac output non-invasively. The NICO® Cardiopulmonary Management System provides continual cardiac output monitoring. With this method, the cardiac
- [in technology](https://www.capnography.com/in-technology/) - In technology Microstream Technology Main-stream Technology For further information on this technology, click on the above For new developments in main stream technology, click here. Opens a new window. Close the window to return back to the siteNon-invasive measurement cardiac output
- [Severe Kyphoscoliosis details](https://www.capnography.com/severe-kyphoscoliosis-details/) - Biphasic carbon dioxide waveform in severe kyphoscoliosis Carbon dioxide waveform recorded in a patient with severe kypho-scoliosis. The CO2 waveform has two humps. Kyphoscoliosis resulted in a compression of the right lung. The compressed right lung had a relatively high airway resistance, was poorly ventilated, and was relatively hypercapnic, whereas the left lung had
- [site management](https://www.capnography.com/site-management/) - Site Details (4th Edition)This site is designed, produced and maintained by Bhavani-Shankar Kodali MD Address Telephone Email Address Department of AnesthesiaBrigham and Women's Hospital75 Francis StreetBoston, MA 02115USATel No: 617 732 8216Fax No: 617 277 2192 Bhavani@capnography.comBSKODALI@BICS.BWH.HARVARD.EDU Assistance was provided by Technical Consultant for site management issuesA Y Kumar MDDepartment of AnesthesiaQueen Elizabeth HospitalBarbados, West
- [contaminated monitors.](https://www.capnography.com/contaminated-monitors/) - Contamination of CO2 sensorThis is a trend capnogram showing sudden increase in the base line as well as height of the waveform and indicates contamination of the carbon dioxide analyzer.
- [expiratory valves.](https://www.capnography.com/expiratory-valves/) - Expiratory Unidirectional valve Expiratory valve - Normal Incompetent expiratory valve The capnogram shows prolonged phase II as well as slanting of descending limb of inspiratory segement. The expiratory unidirectional valve was noted to be fixed in the open position and thus allowing previously exhaled gases, high in CO2, to be rebreathed with each inspiration. The
- [exhaustion of soda lime](https://www.capnography.com/exhaustion-of-soda-lime/) - RebreathingThe base line is elevated from zero. Probably indicates exhaustion of soda lime.
- [rebreathing circuits,](https://www.capnography.com/rebreathing-circuits/) - Signature capnogramCapnogram recorded during the use of Bain anesthetic system / Mapelson D. The base line is elevated from zero. During inspiration, there a small rebreathing wave due to inhalation of carbon dioxide. The extent of CO2 rebreathing depends FGF, tidal volume, and respiratory frequency. Red indicates inspiration.A similar capnogram has been reported during closed
- [Hypoventilation 2](https://www.capnography.com/hypoventilation-2/) - There is a progressively increasing end-tidal PCO2 values. Base line remaining at zero. The shape of the waveform remains normal.
- [given ventilation may suggest low cardiac output](https://www.capnography.com/given-ventilation-may-suggest-low-cardiac-output/) - This animation shows how end-tidal PCO2 changes with decreases in cardiac output.
- [Hyperventilation capnogram](https://www.capnography.com/hyperventilation-capnogram/) - Hyperventilation capnogramDuring hyperventilation, base line remains at zero. However, the height of the capnograms decrease gradually. Progressive depression of cardiac out or metabolism can also decrease the height of the capnograms.
- [Capnometry](https://www.capnography.com/capnometry/) - Clinical Aspects Bhavani Shankar Kodali MD Capnometry Various factors result in either increased or decreased/absent PETCO2. PETCO2 increased CO2 output Pulmonary perfusion Alveolar Ventilation Technical errorsMachine faults FeverMalignant hyperpyrexiaSodium bicarbonateTourniquet releaseVenous CO2 embolism Increased cardiac outputIncreased blood pressure HypoventilationBronchial intubationPartial airway obstructionRebreathing Exhausted CO2 absorberInadequate fresh gas flowsLeaks in breathing systemFaulty ventilatorFaulty valvesPETCO2 decreased CO2 output Pulmonary perfusion Alveolar VentilationTechnical errors Machine faults Hypothermia
- [Dual Plateau capnogram caused by cracked sample filter](https://www.capnography.com/dual-plateau-capnogram-caused-by-cracked-sample-filter-2/) - Dual Plateau capnogram caused by cracked sample filterA dual plateau capnogram was observed by Body et al during anesthesia and IPPV. They found that the cause of the abnormality was due a microscopic crack in the filter membrane separator cartridge of the Ohmeda RGM 5250 gas analyzer. The authors hypothesized that, during the initial phase
- [Sticking Inspiratory unidirectional valve Details](https://www.capnography.com/sticking-inspiratory-unidirectional-valve-details/) - There is downward flip on the plateau. This capnogram was recorded when the inspiratory valve of circle system was not falling back completely into the seat, thereby resulting in partial rebreathing. Red indicates the inspiratory portion of the capnogram.
- [Capnogram recorded during general anesthesia for cesarean section](https://www.capnography.com/capnogram-recorded-during-general-anesthesia-for-cesarean-section/) - Capno Clips Bhavani Shankar Kodali MD Capnogram recorded during general anesthesia for cesarean section. The slope of the phase III is increased. This is a normal physiological variation. Airway obstruction can result in an increase in the phase III as well. Depending on the severity of airway obstruction, phase II can also be prolonged. Occasionally,
- [Ripple effect](https://www.capnography.com/ripple-effect/) - Capno ClipsBhavani Shankar Kodali MD This capnogram was recorded during low frequency controlled ventilation. Cardiogenic oscillations shown during the expiratory plateau and the descending limb waveform occurring as a result of movement of gases in the airway due to cardiac pulsations.
- [Signature capnogram](https://www.capnography.com/signature-capnogram/) - Capno Clips Bhavani Shankar Kodali MD Signature capnogram Capnogram recorded during the use of Bain anesthetic system / Mapelson D. The base line is elevated from zero. During inspiration, there a small rebreathing wave due to inhalation of carbon dioxide. The extent of CO2 rebreathing depends FGF, tidal volume, and respiratory frequency. Red indicates
- [Pitfalls of time capnography   main](https://www.capnography.com/pitfalls-of-time-capnography-main/) - Pitfalls of time capnography Bhavani Shankar Kodali MDTime capnography is a convenient method, commonly used in anesthetic practice to monitor ventilation. There are, however, subtle but important limitations of this process.11. The V/Q status of the lung is more accurately reflected in the slope of phase III in an SBT CO2 trace (volume capnogram) than
- [Capnography in Aortic Cross-Clamping   main](https://www.capnography.com/capnography-in-aortic-cross-clamping-main/) - Capnography in Aortic Cross-Clamping Bhavani Shankar Kodali MD Value of capnography during major vascular surgeryIt has been well explained in this website that end tidal carbon dioxide values (ETCO2) has a very strong relationship to cardiac output. In my opinion, the value of this relationship is grossly underestimated in clinical practice. For a given ventilation,
- [Microstream® Technology Overview](https://www.capnography.com/microsteamotechnology-overview/) - Microstream®Technology OverviewOridion took a completely new approach to capnography in developing its Microstream® technology and FilterLine® components. In order to understand how these products conquer past problems with capnography, it helps to understand how conventional capnography works.Capnography is based on the principle that CO2 molecules absorb infrared radiation at specific wavelengths. The capnograph contains special
- [Microstream Technology Overview](https://www.capnography.com/micro-steamo-technology-overview/) - MicrosteamTechnology OverviewOridion took a completely new approach to capnography in developing its Microstream® technology and FilterLine® components. In order to understand how these products conquer past problems with capnography, it helps to understand how conventional capnography works.Capnography is based on the principle that CO2 molecules absorb infrared radiation at specific wavelengths. The capnograph contains special
- [figure](https://www.capnography.com/figure/) - Capnograms recorded in infants and children using side-stream capnographs. Distortion in CO2 waveforms as a result of dispersion of gases in the sampling line. Phase II and the descending limb can be prolonged. Base line is elevated and phase III can have increased slope.References1. Pascucci RC, Schena JA, Thompson JE. Comparison of a sidestream and
- [Welcome to Capnography.com for learning capnography](https://www.capnography.com/welcome-to-capnography-com-for-learning-capnography-2/) - Capnography is synonymous with patient safety during anesthesia and sedation, and a boon during CPR Since the introduction of the first infrared CO2 measuring and recording apparatus by Luft in 1943, capnography has evolved into an essential component of standard anesthesia monitoring armamentarium.The primary goal of anesthesiologists is to prevent hypoxia, and capnography
- [severe kyphoscoliosis.](https://www.capnography.com/severe-kyphoscoliosis/) - Encyclopedia of capnograms Bhavani Shankar Kodali MDBiphasic carbon dioxide waveform in severe kyphoscoliosisImage1 Carbon dioxide waveform recorded in a patient with severe kypho-scoliosis. The CO2 waveform has two humps. Kyphoscoliosis resulted in a compression of the right lung. The compressed right lung had a relatively high airway resistance, was poorly ventilated, and was relatively
- [endobronchial intubation Details](https://www.capnography.com/endobronchial-intubation-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MDEndobronchial intubation Right mainstem intubation Endotracheal tube pulled back into the trachea Image1 Image2 A biphasic carbon dioxide elimination waveform recorded in a patient with no known lung disease who was found to have a right main-stem bronchial intubation. This capnogram probably occurred as the tip of the endotracheal tube
- [transplanted lung details](https://www.capnography.com/transplanted-lung-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MDLung transplantImage1 Biphasic capnogram recorded in a patient after single lung transplantation. This is due to different populations of alveoli. The first peak represents expired carbon dioxide from allografted lung, which has normal compliance, good perfusion, and good ventilation-perfusion ratios (V/Q). The second peak most likely reflects expired
- [breaks in the water filter of the carbon dioxide analyzer](https://www.capnography.com/breaks-in-the-water-filter-of-the-carbon-dioxide-analyzer/) - Encyclopedia of capnograms Bhavani Shankar Kodali MDDual Plateau capnogram caused by cracked sample filter Image1 A dual plateau capnogram was observed by Body et al during anesthesia and IPPV. They found that the cause of the abnormality was due a microscopic crack in the filter membrane separator cartridge of the Ohmeda RGM 5250 gas analyzer. The
- [Slit Sampling tube (tail-up capnogram) Details](https://www.capnography.com/slit-sampling-tube-tail-up-capnogram-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Image1 Dual waveform capnogramThis capnogram occurs due to sampling leaks in the sampling tube cracks, or a loose connection between sampling tubes and the monitor. It has also been reported due to breaks in the water filter of the carbon dioxide analyzer. Image2 (Provided by Simon Body and James Philips)This shape
- [Expiratory valve defects Details](https://www.capnography.com/expiratory-valve-defects-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Expiratory Unidirectional valve Expiratory valve - Normal Incompetent expiratory valve The capnogram shows prolonged phase II as well as slanting of descending limb of inspiratory segement. The expiratory unidirectional valve was noted to be fixed in the open position and thus allowing previously exhaled gases, high in CO2, to
- [Inspiratory valve defects Details](https://www.capnography.com/inspiratory-valve-defects-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Inspiratory Unidirectional Valve Displaced Inspiratory valve Close up view Normal Inspiratory valve function =CO2 Inspiratory valve Incompetent Plateau is prolonged due to rebreathing An incompetent inspiratory valve will allow exhaled CO2- containing gas to enter the inspiratory limb of the circuit during expiration. During the next inspiration,
- [Inspiration Details](https://www.capnography.com/inspiration-details/) - Encyclopedia of capnograms Bhavani Shankar Kodali MD Image1 Image2 The case report on "Failure To Detect CO2-absorbent Exaustion: Seeing and Believing" by Pond et al is an interesting reading.1 However, the interpretation of the abnormal capnogram as obtained by the authors (figure above) warrants further analysis. First of all, the differential diagnosis of the abnormal capnogram
- [Microstream Technology Overview](https://www.capnography.com/microsteam-technology-overview/) - Micro stream Technology Overview Oridion took a completely new approach to capnography in developing its Microstream® technology and FilterLine® components. In order to understand how these products conquer past problems with capnography, it helps to understand how conventional capnography works. Capnography is based on the principle that CO2 molecules absorb infrared radiation at specific
- [Capnography Definitions](https://www.capnography.com/capnography-definitions/) - DefinitionsBhavani Shankar Kodali MD Capnometry: The measurement and display of carbon dioxide (CO2) on a digitial or analogue monitor. Maximum inspiratory and expiratory CO2 concentrations during a respiratory cycle are displayed.Capnography: A graphic display of instantaneous CO2 concentration (FCO2) versus time or expired volume during a respiratory cycle (CO2 waveform or capnogram) Capnograms: CO2 waveforms
- [Terminology of capnograms](https://www.capnography.com/terminology-of-capnograms/) - Terminology of Capnograms Bhavani Shankar Kodali MD Over the last two decades, time capnography has become a standard of monitoring in anesthesia practice in many countries. Along with the acceptance of this technology, however, there has also been a considerable proliferation of terminology representing the various components of a time capnogram. This ambiguity in terminology
- [At a Glance](https://www.capnography.com/at-a-glance/) - Applications of Capnography Bhavani Shankar Kodali MD Capnography monitors various components of patient and anesthesia circuit/equipment as well as the critical connection between the two. Click on the play button below.
- [Why Capnography ?](https://www.capnography.com/why-capnography/) - Oxygen and carbon dioxide pathway during anesthesia Bhavani Shankar Kodali MD CO2 is typically monitored between patient and anesthesia administration system Why Capnography? Pulse oximeter is a direct monitor to reflect the status of oxygenation of the patient. Capnography, on the other hand, is a indirect monitor and helps in the differential

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