Herein, we aim to describe to evaluate whether the use of ETCO2 in the treatment process can replace pCO2 use in patients scheduled for NIMV treatment in the emergency department. Although there are many studies in the literature comparing pCO2 and ETCO2 values in patients who underwent IMV, there are no studies showing their interchangeable applicability in patients who received NIMV. However, it was found that the difference between pCO2 and ETCO2 increased in situations such as decreased lung perfusion, pulmonary embolism, dead space ventilation, and cardiac arrest. It was found that there is a 1–4 mmHg difference between the pCO2 value and the ETCO2 value in the use of capnography for the monitoring of intubated patients on a mechanical ventilator. Using ETCO2 instead of pCO2 in the monitoring of intensive care patients undergoing IMV is an increasingly common method. ETCO2 is mostly used in the emergency department to verify the location of the endotracheal tube in the intubated patient, to monitor the spontaneous return during cardiopulmonary resuscitation (CPR) in cardiac arrest cases, and to monitor the ventilation status in procedural sedoanalgesia. It is also called end-tidal CO2 (ETCO2) because the measurement is taken from expiratory air. ![]() Ĭapnography is the non-invasive measurement and graphic representation of the partial pressure of CO2 in expiration. Blood gas analysis is an important indicator in the follow-up and treatment of patients, and especially the partial pressure (pCO2) value of the carbon dioxide (CO2) gas dissolved in the blood provides guidance for selecting the mode of the mechanical ventilator and adjusting its settings. Mechanical ventilation (MV) is a frequently used method in treating patients with respiratory distress because it reduces gas exchange and respiratory work and has two types of use: invasive mechanical ventilation (IMV) and non-invasive mechanical ventilation (NIMV). When the complaints at admission to the emergency department are evaluated, the rate of dyspnea and respiratory distress is 2–3%. The ETCO2 level was found to be different in our patients who received NIMV treatment, which could not be used instead of the pCO2 level. ![]() There was a significant difference between the controlled pCO2 values and ETCO2 values at the first hour of NIMV treatment (Z: − 10.640, p < 0.001). The mean of ETCO2 values measured simultaneously was 33.6 ± 10.1. The mean pCO2 values were measured as 52.6 ± 13.2. The mean age of the patients included in the study was 69.1 ± 12.2 years. 64.2% (99 patients) of the patients included in the study were male, and 35.8% (55 patients) were female. General characteristics of the patients and the pCO2 and ETCO2 values were measured in the blood gas 1 h after the NIMV application was started. Patients who applied to the emergency department with respiratory distress between March 2019 and January 2020, who were diagnosed with acute cardiogenic edema or acute chronic obstructive pulmonary disease (COPD) exacerbation, and who needed NIMV were included in the study. We aimed to evaluate whether the use of ETCO2 in the treatment process can replace pCO2 use in patients scheduled for NIMV treatment in the emergency department. Although there are many studies in the literature comparing the partial pressure of carbon dioxide (pCO2) and end-tidal CO2 (ETCO2) values in patients who underwent IMV (invasive mechanical ventilation), there are no studies showing their interchangeable applicability in patients who received NIMV (non-IMV). Capnography is the non-invasive measurement and graphic representation of the partial pressure of CO2 in expiration.
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