의식 저하로 내원한 중독 환자들에 대한 호기말 이산화탄소분압 관찰의 효과
Effect of ETCO2 monitoring of poisoning patients with decreased mental state in ED
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Purpose: This study aimed to analyse the effect of End-Tidal Carbon Dioxide (ETCO2) monitoring on patients who had been poisoned and presented in the emergency department with decreased consciousness. Methods: The data of patients over 18 years old presenting with poisoning from 2016 to 2020 was collected from the emergency department. We retrospectively analyzed their medical records, and defined patients with a Glasgow Coma Scale (GCS) score of 9 or less as having decreased consciousness. We divided the patients into two groups, one with ETCO2 monitoring and the other without, and the difference between the two groups was compared. Results: 168 patients participated in this study and 83 (49.4%) of them belonged to the ETCO2 monitoring group. In this group, the interval between arterial blood tests was statistically significantly longer and the rate of intubation was lower. In addition, in the monitoring group, the incidence of pneumonia and the rate of poor prognosis was not significantly higher. Conclusion: Although ETCO2 monitoring does not directly affect the prognosis of poisoned patients with decreased consciousness, it should be actively done as it can help to adequately treat patients while avoiding invasive techniques or unnecessary intubation.
Abstract
Purpose: This study aimed to analyse the effect of End-Tidal Carbon Dioxide (ETCO2) monitoring on patients who had been poisoned and presented in the emergency department with decreased consciousness. Methods: The data of patients over 18 years old presenting with poisoning from 2016 to 2020 was collected from the emergency department. We retrospectively analyzed their medical records, and defined patients with a Glasgow Coma Scale (GCS) score of 9 or less as having decreased consciousness. We divided the patients into two groups, one with ETCO2 monitoring and the other without, and the difference between the two groups was compared. Results: 168 patients participated in this study and 83 (49.4%) of them belonged to the ETCO2 monitoring group. In this group, the interval between arterial blood tests was statistically significantly longer and the rate of intubation was lower. In addition, in the monitoring group, the incidence of pneumonia and the rate of poor prognosis was not significantly higher. Conclusion: Although ETCO2 monitoring does not directly affect the prognosis of poisoned patients with decreased consciousness, it should be actively done as it can help to adequately treat patients while avoiding invasive techniques or unnecessary intubation.
참고문헌 (23)
- Lam SW, "Toxicology today : what you need to know now", J Pharm Pract, 24(2), pp.174~188 (2011)
- Aminiahidashti H, "Applications of End-Tidal Carbon Dioxide(ETCO2)Monitoring in Emergency Department; a Narrative Review", Emerg(Tehran), 6(1), pp.e5~ (2018)
- Laher AE, "A review of hemodynamic monitoring techniques, methods and devices for the emergency physician", Am J Emerg Med, 35(9), pp.1335~1347 (2017)
- Anderson CT, "Carbon dioxide kinetics and capnography during critical care", Crit Care, 4(4), pp.207~215 (2000)
- Smalhout B, "An atlas of capnography" (1981), Kerchebosch-Zeist
- M W, "Respiratory monitoring : a ten year perspective", J Clin Monit, 6, pp.217~225 (1990)
- Sandroni C, "Capnography during cardiac arrest", Resuscitation, 132, pp.73~77 (2018)
- Ornato JP GE, "Effect of cardiopulmonary resuscitation compression rateon end-tidal carbon dioxide concentration and arterial pressure in man", Crit Care Med, 16, pp.241~245 (1988)
- Burton JH, "Does end tidal carbon dioxide monitoring detect respiratory events prior to current sedation monitoring practices?", AcadEmerg Med, 13, pp.500~504 (2006)
- Deitch K, "Does end tidal CO2 monitoring during emergency department procedural sedation and analgesia with propofol decrease the incidence of hypoxic events? A randomized,controlled trial", Ann Emerg Med, 55, pp.258~264 (2010)
- Saunders R, "Patient safety during procedural sedation using capnography monitoring : a systematic review and meta-analysis", BMJ Open, 7(6), pp.e013402~ (2017)
- Paxiuta J, "Radial artery pseudoaneurysm:rare complication of a frequent procedure", BMJ Case Rep, 2017, pp.bcr2016218~ (2017)
- Kim D, "Iatrogenic Radial Artery Injuries : Variable Injury Patterns, Treatment Times, and Outcomes", Hand(N Y), 16(1), pp.93~98 (2021)
- Blum FE, "Reevaluation of the utilization of arterial blood gas analysis in the Intensive Care Unit : effects on patient safety and patient outcome", J Crit Care, 30(2), pp.438.e1~438.e5 (2015)
- Eizadi-Mood N, "Comparison of arterial and capillary blood gas values in poisoning department assessment", Hum Exp Toxicol, 28(10), pp.665~670 (2009)
- Lermuzeaux M, "Superiority of transcutaneous CO2 over endtidal CO2 measurement for monitoring respiratory failure in nonintubated patients : A pilot study", Crit Care, 31(1), pp.150~156 (2016)
- Manifold CA, "CAPNOGRAPHY FOR THE NONINTUBATED PATIENT IN THE EMERGENCY SETTING", J Emerg Med, 45(4), pp.626~632 (2013)
- Beauchamp GA, "Poisonings Associated with Intubation: US National Poison Data System Exposures 2000-2013", J Med Toxicol, 12(2), pp.157~164 (2016)[DOI]
- Wittekamp BH, "Clinical review : post-extubation laryngeal edema and extubation failure in critically ill adult patients", Crit Care, 13(6), pp.233~ (2009)
- Homsi JT, "A closed claims analysis of vocal cord injuries related to endotracheal intubation between 2004 and 2015", J Clin Anesth, 61, pp.109687~ (2015)
- Liisanantti J, "Aspiration pneumonia following severe self-poisoning", Resuscitation, 56(1), pp.49~53 (2003)
- Orso D, "Endotracheal intubation to reduce aspiration events in acutely comatose patients : a systematic review", Scand J Trauma Resusc Emerg Med, 28(1), pp.116~125 (2020)
- Maria K., "Risk Factors of Pneumonia Associated with Mechanical Ventilation", Int J Environ Res Public Health, 17, pp.656~663 (2020)