Term of Award

Spring 1995

Degree Name

Master of Nursing

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

Camille Stern

Committee Member 1

Marilyn Buck

Committee Member 2

Charlene M. Hanson

Abstract

Background: Adequate ventilation plays a significant role in the recovery of the critically ill patient. The patient in the critical care unit is at risk for developing complications due to hypoventilation as a result of many pathophysiologic processes. The arterial blood gas sample has always been the standard for monitoring ventilatory status. Recently, anesthesiologists and respiratory therapists have used end tidal carbon dioxide monitoring for stable patients in controlled situations. This method can reduce the cost of hospitalization by reducing the number of expensive, invasive procedures and reduce the pain and risk of frequent arterial punctures. Capnography might be a valuable adjunct to invasive monitoring in critically ill adults in the intensive care unit.

Objective: The objective of this study was to determine if there is a relationship between end tidal carbon dioxide monitoring and the partial pressure of carbon dioxide in arterial blood gases.

Methods: Fifty - six adult patients requiring mechanical ventilation from the surgical intensive care unit were enrolled . A correlation design was used to compare the partial pressure of carbon dioxide in arterial blood gases and the end tidal carbon dioxide measurements. The patients were mechanically ventilated for at least twenty - four hours. No greater than three samples were collected for each patient in the study. End tidal carbon dioxide measurements were documented simultaneously with the arterial blood draw.

Results: End tidal carbon dioxide values showed a strong relationship with the partial pressure of carbon dioxide in arterial blood gases ( r = 0.64, p< 0.05).

Conclusions: In this patient sample, end tidal carbon dioxide values showed a strong correlation with the partial pressure of carbon dioxide in arterial blood gases. Increasing or decreasing values of end tidal carbon dioxide could alert the practitioner to an alteration in ventilation and appropriate action could be taken. Monitoring the end tidal carbon dioxide values could help reduce the number of arterial blood gases required, therefore decreasing the cost and risk of frequent arterial punctures.

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