Journal of Clinical Monitoring and Computing

, Volume 21, Issue 6, pp 341–344 | Cite as

A system of classification for the clinical applications of capnography



We have attempted to list all the clinical applications of capnography described to date and classify them into categories. From an extensive Pubmed search 46 clinical applications of capnography were listed. To classify these we used six categories- Airway, Breathing, Circulation, Anesthetic Delivery Apparatus, Homeostasis and Non-perioperative. This list collates the described uses of capnography and this system of classification provides an aide-de-memoir in anesthesia education and simulation.


monitoring-capnography review of literature-clinical applications of capnography system of classification anesthesia education and simulation 


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Department and institution to which work should be attributed: Anesthesia, Sunnybrook Health Sciences Centre.


  1. 1.
    Williamson JA, Webb RK, Cockings J, Morgan C. The Australian incident monitoring study. The capnograph: applications and limitations – an analysis of 2000 incident reports. Anaesth Intensive Care 1993;21:551–557PubMedGoogle Scholar
  2. 2.
    Gravenstein N, Lampotang S, Beneken JE. Factors influencing capnography in the Bain circuit. J Clin Monit 1985;1:6–10PubMedGoogle Scholar
  3. 3.
    Lampotang S, Gravenstein JS, Euliano TY, van Meurs WL, et al. Influence of pulse oximetry and capnography on time to diagnosis of critical incidents in anesthesia: a pilot study using a full-scale patient simulator. J Clin Monit Comput 1998;14:313–321PubMedCrossRefGoogle Scholar
  4. 4.
    Tripathi M, Pandey M. Atypical “Tails-up” capnograph due to breach in the sampling tube of side-Stream capnometer. J Clin Monit Comput 2000;16:17–20PubMedCrossRefGoogle Scholar
  5. 5.
    Ravishankar M, Chatterjee S. Fractional utilisation of fresh gas by breathing systems without carbon dioxide absorption. Br J Anaesth 1993;71:706–707CrossRefGoogle Scholar
  6. 6.
    Bhavani-Shankar K, Philip JH. Defining segments and phases of a time capnogram. Anesth Analg 2000;91:973–977PubMedCrossRefGoogle Scholar
  7. 7.
    Berman LS, Pyles ST. Capnographic detection of anaesthesia circle valve malfunctions. Can J Anaesth 1988;35:473–475PubMedGoogle Scholar
  8. 8.
    Goldberg JS, Rawle PR, Zehnder JL, Sladen RN. Colorimetric end-tidal carbon dioxide monitoring for tracheal intubation. Anesth Analg 1990;70:191–194PubMedGoogle Scholar
  9. 9.
    Birmingham PK, Cheney FW, Ward RJ. Esophageal intubation: a review of detection techniques. Anesth Analg 1986;65:886–891PubMedCrossRefGoogle Scholar
  10. 10.
    Bourke DL, Biehl J. The laryngotracheal topical anesthesia kit with capnography for difficult endotracheal intubation. Anesth Analg 1999;88:943–945PubMedCrossRefGoogle Scholar
  11. 11.
    Mahajan R, Batra YK, Kumar S. Another cause of obstruction of the endotracheal tube during laparoscopic cholecystectomy. Can J Anaesth 2004;51:1053PubMedGoogle Scholar
  12. 12.
    Shafieha MJ, Sit J, Kartha R, Sabnis L, Hajianpour B, Pappas AL, Yu E, Elam J, Balagot RC. End-tidal CO2 analyzers in proper positioning of the double-lumen tubes. Anesthesiology 1986;64:844–845PubMedGoogle Scholar
  13. 13.
    Agro F, Frass M, Benumof JL, Krafft P. Current status of the Combitube™: a review of the literature. J Clin Anesth 2002;14:307–314PubMedCrossRefGoogle Scholar
  14. 14.
    Huitink JM, Buitelaar DR, Schutte PF. Awake fibrecapnic intubation: a novel technique for intubation in head and neck cancer patients with a difficult airway. Anaesthesia 2006;61:449–452PubMedCrossRefGoogle Scholar
  15. 15.
    Omoigui S, Glass P, Martel DL, Watkins K, Williams KL, Whitefield SM, Wooten LL. Blind nasal intubation with audio-capnometry. Anesth Analg 1991;72:392–393PubMedCrossRefGoogle Scholar
  16. 16.
    Mallick A, Venkatanath D, Elliot SC, Hollins T, Nanda Kumar CG. A prospective randomized controlled trial of capnography versus bronchoscopy for Blue Rhino percutaneous tracheostomy. Anaesthesia 2003;58:864–868PubMedCrossRefGoogle Scholar
  17. 17.
    Depierraz B, Ravussin P, Brossard E, Monnier P. Percutaneous transtracheal jet ventilation for paediatric endoscopic laser treatment of laryngeal and subglottic lesions. Can J Anaesth 1994;41:1200–1207PubMedGoogle Scholar
  18. 18.
    Valentin N, Lomholt B, Thorup M. Halothane anaesthesia with spontaneous respiration for tonsillectomy in children. Acta Anaesthesiol Scand 1982;26:53–55PubMedGoogle Scholar
  19. 19.
    Srinivasa V, Kodali BS. Capnometry in the spontaneously breathing patient. Curr Opin Anaesthesiol 2004;17:517–520PubMedCrossRefGoogle Scholar
  20. 20.
    Bissinger U, Lenz G, Reiter A, Albrecht T, Schorer R. (Monitoring neuromuscular function: capnography versus relaxometry) (Article in German). Anasthesiol Intensivmed Notfallmed Schmerzther 1993;28:359–362PubMedGoogle Scholar
  21. 21.
    Saura P, Blanch L, Lucangelo U, Fernandez R. Use of capnography to detect hypercapnic episodes during weaning from mechanical ventilation. Intensive Care Med 1996;22:374–381PubMedCrossRefGoogle Scholar
  22. 22.
    Werner O, Malmkvist G, Beckman A, et al. CO2 elimination from each lung during endobronchial anaesthesia. Br J Anaesth 1984;56:995–1001PubMedCrossRefGoogle Scholar
  23. 23.
    Krauss B, Deykin A, Lam A, Ryoo JJ, Hampton DR, Schmitt PW, Falk JL. Capnogram shape in obstructive lung disease. Anesth Analg 2005;100:884–888PubMedCrossRefGoogle Scholar
  24. 24.
    Fletcher R, Jonson B, Cumming G, Brew J. The concept of deadspace with special reference to the single breath test for carbon dioxide. Br J Anaesth 1981;53:77–88PubMedCrossRefGoogle Scholar
  25. 25.
    Isserles SA, Breen PH. Can changes in end-tidal PCO2 measure changes in cardiac output?. Anesth Analg 1991;73:808–814PubMedCrossRefGoogle Scholar
  26. 26.
    Burrows FA. Physiologic deadspace, venous admixture, and the arterial to end-tidal carbon dioxide difference in infants and children undergoing cardiac surgery. Anesthesiology 1989;70:219–225PubMedCrossRefGoogle Scholar
  27. 27.
    Leigh MD, Jones JC, Mottley HL. The expired carbon dioxide as continuous guide of the pulmonary and circulatory systems during anaesthesia and surgery. J Thoracic and Cardiovasc Surg 1961;41:597–610Google Scholar
  28. 28.
    Reid CW, Martineau RJ, Miller DR, Sullivan PJ, Hull KA, Samson B. A comparison of end-tidal and transcutaneous PCO2 measurements during anaesthesia. Can J Anaesth 1990;37:89Google Scholar
  29. 29.
    Hoka S, Okamoto H, Yamaura K, Takahashi S, Tominaga R, Yasui H. Removal of retained air during cardiac surgery with transesophageal echocardiography and capnography. J Clin Anesth 1997;9:457–461PubMedCrossRefGoogle Scholar
  30. 30.
    Haryadi DG, Orr JA, Kuck K, McJames S, Westenskow DR. Partial CO2 rebreathing indirect Fick technique for non-invasive measurement of cardiac output. J Clin Monit Comput 2000;16:361–374PubMedCrossRefGoogle Scholar
  31. 31.
    Maslow A, Stearns G, Bert A, Feng W, Price D, Schwartz C, Mackinnon S, Rotenberg F, Hopkins R, Cooper G, Singh A, Loring SH. Monitoring end-tidal carbon dioxide during weaning from cardiopulmonary bypass in patients without significant lung disease. Anesth Analg 2001;92:306–313PubMedCrossRefGoogle Scholar
  32. 32.
    Cote CJ, Liu LM, Szyfelbein SK, Firestone S, Goudsouzian NG, Welch JP, Daniels AL. Intraoperative events diagnosed by expired carbon dioxide monitoring in children. Can Anaesth Soc J 1986;33:315–320PubMedCrossRefGoogle Scholar
  33. 33.
    Schmitz BD, Shapiro BA. Capnography. Respir Care Clin N Am 1995;1:107–117PubMedGoogle Scholar
  34. 34.
    Marik PE. Sublingual capnography: a clinical validation study. Chest 2001;120:923–927PubMedCrossRefGoogle Scholar
  35. 35.
    Wabha RWM, Mamazza J. Ventilatory requirements during laparoscopic cholecystectomy. Can J Anaesth 1993;40:206–210Google Scholar
  36. 36.
    McCrirrick A, Warwick JP, Thomas TA. Capnography and awareness. Anaesthesia 1992;47:1102–1103PubMedCrossRefGoogle Scholar
  37. 37.
    Sakurazawa S, Saito S, Yamada M, Nishihara F, Goto F. Carbon dioxide exhalation temporarily increases during electroconvulsive therapy. J of Anesth 2000;20:68–70CrossRefGoogle Scholar
  38. 38.
    Marik PE. Monitoring therapeutic interventions in critically ill septic patients. Nutr Clin Pract 2004;19:423–432PubMedCrossRefGoogle Scholar
  39. 39.
    Grmec S, Mally S. Prehospital determination of tracheal tube placement in severe head injury. Emerg Med J 2004;21:518–520PubMedGoogle Scholar
  40. 40.
    Rhoades C, Thomas F. Capnography: beyond the numbers. Air Med J 2002;21:43–48PubMedCrossRefGoogle Scholar
  41. 41.
    Ward KR, Menegazzi JJ, Zelenak RR, Sullivan RJ, Jr McSwain NE. A comparison of chest compressions between mechanical and manual CPR by monitoring end-tidal PCO2 during human cardiac arrest. Ann Emerg Med 1993;22:669–674PubMedCrossRefGoogle Scholar
  42. 42.
    Terndrup TE, Rhee J. Available ventilation monitoring methods during pre-hospital cardiopulmonary resuscitation. Resuscitation 2006;71:10–18PubMedCrossRefGoogle Scholar
  43. 43.
    Burns SM, Carpenter R, Blevins C, Bragg S, et al. Detection of inadvertent airway intubation during gastric tube insertion: Capnography versus a colorimetric carbon dioxide detector. Am J Crit Care 2006;15:188–195PubMedGoogle Scholar
  44. 44.
    Hsieh KS, Lee CL, Lin CC, Wu SN. Quantitative analysis of end-tidal carbon dioxide during mechanical and spontaneous ventilation in infants and young children. Pediatr Pulmonol 2001; 32:453–458PubMedCrossRefGoogle Scholar
  45. 45.
    Lightdale JR, Goldmann DA, Feldman HA, Newburg AR, DiNardo JA, Fox VL. Microstream capnography improves patient monitoring during moderate sedation: a randomized, controlled trial. Pediatrics 2006;117:1170–1178CrossRefGoogle Scholar
  46. 46.
    Lukic KZ,Urch B, Fila M, Faughnan ME, Silverman F. A novel application of capnography during controlled human exposure to air pollution. Biomed Eng Online 2006;5:54PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  1. 1.Department of Anesthesia, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada

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