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 Why Continuous ETCO2?

Hypoventilation and apnea precede hypoxia, therefore, end-tidal carbon dioxide should be affected before oxygen saturation.1 Likewise, continuous monitoring of EtCO2 has been demonstrated to show greater sensitivity for detecting episodes of respiratory compromise.2

Overdyk et al. continuously monitored postoperative patients (n=178) receiving patient-controlled analgesia on the ward who were assigned to receive morphine or meperdine by their surgeons with EtCO2 and SpO2 in order to determine the sensitivity of each parameter to episodes of respiratory compromise.2

Insidence of respiratory depression as definted by EtCO2 and SpO2 in postoperative patients receiving patient controlled analgesia2
Hypoxic Respiratory Failure Hypercapnic Respiratory Failure
Incidence of patients with bradypnea (PR <10 for ≥3 minutes) as detected by EtCO2 41%
Incidence of patients with desaturation (SpO2 <90% for ≥3 minutes) 12%
Incidence of patients with bradypnea (PR <10 for ≥2 minutes) as detected by EtCO2 58%
Incidence of patients with desaturation (SpO2 <90% for ≥2 minutes) 21%
Percentage of desaturation events preceded by bradypnea 28%

 Why Continuous ETCO2?

Hypoventilation and apnea precede hypoxia, therefore, end-tidal carbon dioxide should be affected before oxygen saturation.1 Likewise, continuous monitoring of EtCO2 has been demonstrated to show greater sensitivity for detecting episodes of respiratory compromise.2

Overdyk et al. continuously monitored postoperative patients (n=178) receiving patient-controlled analgesia on the ward who were assigned to receive morphine or meperdine by their surgeons with EtCO2 and SpO2 in order to determine the sensitivity of each parameter to episodes of respiratory compromise.2

Insidence of respiratory depression as definted by EtCO2 and SpO2 in postoperative patients receiving patient controlled analgesia2
Hypoxic Respiratory Failure Hypercapnic Respiratory Failure
Incidence of patients with bradypnea (PR <10 for ≥3 minutes) as detected by EtCO2 41%
Incidence of patients with desaturation (SpO2 <90% for ≥3 minutes) 12%
Incidence of patients with bradypnea (PR <10 for ≥2 minutes) as detected by EtCO2 58%
Incidence of patients with desaturation (SpO2 <90% for ≥2 minutes) 21%
Percentage of desaturation events preceded by bradypnea 28%

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  • 1. Cacho, G., Perez-Calle, J. L., Barbado, A., Lledo, J. L., Ojea, R., & Fernandez-Rodriguez, C. M. Capnography is superior to pulse oximetry for the detection of respiratory depression during colonoscopy. Rev Esp Enferm Dig. 2010;102(2):86-89.
  • 2. Overdyk, F. J., Carter, R., Maddox, R. R., Callura, J., Herrin, A. E., & Henriquez, C. Continuous oximetry/capnometry monitoring reveals frequent desaturation and bradypnea during patient-controlled analgesia. Anesth Analg. 2007;105(2):412-418.
  • 5. Maddox, R. R., Oglesby, H., Williams, C. K., Fields, M., & Danello, S. (2008). Continuous Respiratory Monitoring and a "Smart" Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period
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