The Experts below are selected from a list of 1716 Experts worldwide ranked by ideXlab platform
Shinji Yamamori - One of the best experts on this subject based on the ideXlab platform.
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A novel mainstream capnometer system for polysomnography integrated with measurement of nasal pressure and thermal airflow
2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2014Co-Authors: Kota Saeki, Fumihiko Takatori, Masayuki Inoue, Yuya Baba, Naoki Kobayashi, Shinji YamamoriAbstract:Capnometry is a method to measure carbon dioxide (CO2) in exhaled gas and its use during polysomnography (PSG) for diagnostic of sleep apnea-hypopnea syndrome is expanding. However, some problems exist for using capnometer in combination with other respiratory monitoring devices because Capnometry requires additional sampling cannula or airway adapter attached to patients. To resolve these problems, we developed a novel mainstream capnometer system for PSG, which is designed to integrate multiple devices for measuring respiratory parameters. This system may provide comfortable and stable PSG including Capnometry. We evaluated the basic performance of this system using a spontaneous breathing model. The result indicates that this newly developed system works adequately in PSG and moreover has superior characteristics of capnography signal and measurement stability against displacement of sensors, compared to conventional devices.
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EMBC - A novel mainstream capnometer system for polysomnography integrated with measurement of nasal pressure and thermal airflow.
2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2014Co-Authors: Kota Saeki, Fumihiko Takatori, Masayuki Inoue, Yuya Baba, Naoki Kobayashi, Shinji YamamoriAbstract:Capnometry is a method to measure carbon dioxide (CO(2)) in exhaled gas and its use during polysomnography (PSG) for diagnostic of sleep apnea-hypopnea syndrome is expanding. However, some problems exist for using capnometer in combination with other respiratory monitoring devices because Capnometry requires additional sampling cannula or airway adapter attached to patients. To resolve these problems, we developed a novel mainstream capnometer system for PSG, which is designed to integrate multiple devices for measuring respiratory parameters. This system may provide comfortable and stable PSG including Capnometry. We evaluated the basic performance of this system using a spontaneous breathing model. The result indicates that this newly developed system works adequately in PSG and moreover has superior characteristics of capnography signal and measurement stability against displacement of sensors, compared to conventional devices.
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finite element modeling of a mainstream capnometer system for non intubated pediatric patients requiring oxygen administration
ASME 2013 Conference on Frontiers in Medical Devices: Applications of Computer Modeling and Simulation FMD 2013, 2013Co-Authors: Fumihiko Takatori, Shinji Yamamori, Masayuki Inoue, Seiki Abe, Matthew R Maltese, Vinay M Nadkarni, Katsuyuki MiyasakaAbstract:Capnometry is the standard of care to measure the amount of carbon dioxide in the proximal airway, detect apnea, tracheal tube dislodgement, and effectiveness of ventilation during invasive mechanical ventilation in critically ill infants, children and adults [1]. Capnometry is not yet standard practice for non-invasively supported or ventilated patients, due to dead space ventilation, inspiratory gas washout, gas entrainment, and potential for rebreathing of gas. Potential Capnometry use in non-intubated patients could identify impending respiratory failure, obstructed airways, and improve the safety and effectiveness of non-invasive support for infants and children [2].Copyright © 2013 by ASME
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Flow-Through Versus Sidestream Capnometry for Detection of End Tidal Carbon Dioxide in the Sedated Patient
Journal of Clinical Monitoring and Computing, 2009Co-Authors: Derek J. Sakata, Shinji Yamamori, Isao Matsubara, Nishant A. Gopalakrishnan, Dwayne R. Westenskow, Julia L. White, Talmage D. Egan, Nathan L. PaceAbstract:Background End tidal carbon dioxide (ETCO_2) in non-intubated patients can be monitored using either sidestream or flow-through Capnometry [Yamamori et al., J Clin Monit Comput 22(3):209–220, 2008]. The hypothesis of this validation study is that, flow-through Capnometry will yield a more accurate estimate of ETCO_2 than sidestream Capnometry when evaluated in a bench study during low tidal volumes and high oxygen administration via nasal cannula. Secondarily, when ETCO_2 from each is compared to arterial CO_2 (PaCO_2) during a study in which healthy, non-intubated volunteers are tested under normocapnic, hypocapnic and hypercapnic conditions, the flow-through capnometer will resemble PaCO_2 more closely than the sidestream capnometer. This will be especially true during periods of lower minute ventilation and high oxygen flow rates via mask in non-intubated, remifentanil sedated, healthy volunteers whose physiologic deadspace is small. Methods The performance of a flow-through (cap-ONE^®, Nihon Kohden, Tokyo, Japan) and a sidestream (Microcap^® Smart CapnoLine Plus^®, Oridion Inc., Needham, MA) capnometer were compared in a bench study and a volunteer trial. A bench study evaluated ETCO_2 accuracy using waveforms generated via mechanical lungs during low tidal volumes and high oxygen flow rates. A volunteer study compared the ETCO_2 for each capnometer against PaCO_2 during sedation in which 8 l O_2 was delivered via mask rather than the nasal cannula. Results In the bench study, the flow-through capnometer gave slightly higher values of ETCO_2 during high-flow oxygen and no discernable differences during variable tidal volumes. Bland and Altman plots comparing ETCO_2 to PaCO_2 showed essentially equal performance between the two capnometers in the volunteers. Conclusions Within a wide limit of agreement between the volunteer and bench study, flow-through and sidestream Capnometry performed equally well during bench testing and in non-intubated, sedated patients.
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FLOW-THROUGH VERSUS SIDESTREAM Capnometry FOR DETECTION OF END TIDAL CARBON DIOXIDE IN THE SEDATED PATIENT
Journal of Clinical Monitoring and Computing, 2009Co-Authors: Derek J. Sakata, Shinji Yamamori, Isao Matsubara, Nishant A. Gopalakrishnan, Dwayne R. Westenskow, Julia L. White, Talmage D. Egan, Nathan L. PaceAbstract:Background End tidal carbon dioxide (ETCO2) in non-intubated patients can be monitored using either sidestream or flow-through Capnometry [Yamamori et al., J Clin Monit Comput 22(3):209–220, 2008]. The hypothesis of this validation study is that, flow-through Capnometry will yield a more accurate estimate of ETCO2 than sidestream Capnometry when evaluated in a bench study during low tidal volumes and high oxygen administration via nasal cannula. Secondarily, when ETCO2 from each is compared to arterial CO2 (PaCO2) during a study in which healthy, non-intubated volunteers are tested under normocapnic, hypocapnic and hypercapnic conditions, the flow-through capnometer will resemble PaCO2 more closely than the sidestream capnometer. This will be especially true during periods of lower minute ventilation and high oxygen flow rates via mask in non-intubated, remifentanil sedated, healthy volunteers whose physiologic deadspace is small.
Nathan L. Pace - One of the best experts on this subject based on the ideXlab platform.
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Flow-Through Versus Sidestream Capnometry for Detection of End Tidal Carbon Dioxide in the Sedated Patient
Journal of Clinical Monitoring and Computing, 2009Co-Authors: Derek J. Sakata, Shinji Yamamori, Isao Matsubara, Nishant A. Gopalakrishnan, Dwayne R. Westenskow, Julia L. White, Talmage D. Egan, Nathan L. PaceAbstract:Background End tidal carbon dioxide (ETCO_2) in non-intubated patients can be monitored using either sidestream or flow-through Capnometry [Yamamori et al., J Clin Monit Comput 22(3):209–220, 2008]. The hypothesis of this validation study is that, flow-through Capnometry will yield a more accurate estimate of ETCO_2 than sidestream Capnometry when evaluated in a bench study during low tidal volumes and high oxygen administration via nasal cannula. Secondarily, when ETCO_2 from each is compared to arterial CO_2 (PaCO_2) during a study in which healthy, non-intubated volunteers are tested under normocapnic, hypocapnic and hypercapnic conditions, the flow-through capnometer will resemble PaCO_2 more closely than the sidestream capnometer. This will be especially true during periods of lower minute ventilation and high oxygen flow rates via mask in non-intubated, remifentanil sedated, healthy volunteers whose physiologic deadspace is small. Methods The performance of a flow-through (cap-ONE^®, Nihon Kohden, Tokyo, Japan) and a sidestream (Microcap^® Smart CapnoLine Plus^®, Oridion Inc., Needham, MA) capnometer were compared in a bench study and a volunteer trial. A bench study evaluated ETCO_2 accuracy using waveforms generated via mechanical lungs during low tidal volumes and high oxygen flow rates. A volunteer study compared the ETCO_2 for each capnometer against PaCO_2 during sedation in which 8 l O_2 was delivered via mask rather than the nasal cannula. Results In the bench study, the flow-through capnometer gave slightly higher values of ETCO_2 during high-flow oxygen and no discernable differences during variable tidal volumes. Bland and Altman plots comparing ETCO_2 to PaCO_2 showed essentially equal performance between the two capnometers in the volunteers. Conclusions Within a wide limit of agreement between the volunteer and bench study, flow-through and sidestream Capnometry performed equally well during bench testing and in non-intubated, sedated patients.
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FLOW-THROUGH VERSUS SIDESTREAM Capnometry FOR DETECTION OF END TIDAL CARBON DIOXIDE IN THE SEDATED PATIENT
Journal of Clinical Monitoring and Computing, 2009Co-Authors: Derek J. Sakata, Shinji Yamamori, Isao Matsubara, Nishant A. Gopalakrishnan, Dwayne R. Westenskow, Julia L. White, Talmage D. Egan, Nathan L. PaceAbstract:Background End tidal carbon dioxide (ETCO2) in non-intubated patients can be monitored using either sidestream or flow-through Capnometry [Yamamori et al., J Clin Monit Comput 22(3):209–220, 2008]. The hypothesis of this validation study is that, flow-through Capnometry will yield a more accurate estimate of ETCO2 than sidestream Capnometry when evaluated in a bench study during low tidal volumes and high oxygen administration via nasal cannula. Secondarily, when ETCO2 from each is compared to arterial CO2 (PaCO2) during a study in which healthy, non-intubated volunteers are tested under normocapnic, hypocapnic and hypercapnic conditions, the flow-through capnometer will resemble PaCO2 more closely than the sidestream capnometer. This will be especially true during periods of lower minute ventilation and high oxygen flow rates via mask in non-intubated, remifentanil sedated, healthy volunteers whose physiologic deadspace is small.
Matthias Boentert - One of the best experts on this subject based on the ideXlab platform.
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Sleep-related breathing disorders in facioscapulohumeral dystrophy
Sleep and Breathing, 2019Co-Authors: Maya Runte, Jens Spiesshoefer, Peter Young, Michael Dreher, Anna Heidbreder, Tobias Brix, Matthias BoentertAbstract:Purpose Severe manifestations of facioscapulohumeral dystrophy (FSHD) may be associated with sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA) and nocturnal hypoventilation (NH), but prevalence data are scarce. In patients with respiratory muscle weakness, detection of NH can be facilitated by transcutaneous Capnometry, but respective data derived from FSHD patients have not yet been published. Methods We collected sleep studies and Capnometry recordings from 31 adult patients with genetically confirmed FSHD who were admitted to our sleep laboratory for first-ever evaluation of sleep-related breathing. Indications for admission included non-restorative sleep, morning headache, or excessive daytime sleepiness. In addition, sleep studies were initiated if symptoms or signs of respiratory muscle weakness were present. Thirty-one subjects with insomnia served as controls for comparison of respiratory measures during sleep. Results In the FSHD group, 17/31 (55%) patients showed OSA and 8 (26%) had NH. NH would have been missed in 7/8 patients if only oximetry criteria of hypoventilation had been applied. Capnography results were correlated with disease severity as reflected by the Clinical Severity Score (CSS). Non-invasive ventilation (NIV) was started in 6 patients with NH and 3 individuals with OSA. Nocturnal continuous positive airway pressure was administered to 2 patients, and positional therapy was sufficient in 4 individuals. In patients initiated on NIV, nocturnal gas exchange already improved in the first night of treatment. Conclusions SDB is common in adult patients with FSHD complaining of sleep-related symptoms. It may comprise OSA, NH, and most often, the combination of both. Sleep-related hypercapnia is associated with disease severity. Transcutaneous Capnometry is superior to pulse oximetry for detection of NH.
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Sleep-disordered breathing and effects of non-invasive ventilation on objective sleep and nocturnal respiration in patients with myotonic dystrophy type I.
Neuromuscular disorders : NMD, 2019Co-Authors: Jens Spiesshoefer, Maya Runte, Peter Young, Michael Dreher, Anna Heidbreder, Tobias Brix, Matthias BoentertAbstract:Abstract Patients with myotonic dystrophy type I (DM1) may develop nocturnal hypoventilation, requiring non-invasive ventilation. Data on long-term adherence to non-invasive ventilation, or sleep and ventilation outcomes are scarce. We retrospectively collected baseline polysomnography and Capnometry results from 36 adult patients with sleep-related symptoms (42.9 ± 12.5 years, 20 female), plus follow-up sleep study records from those treated with non-invasive ventilation. Sleep-disordered breathing was found in 33 patients (91.7%) including 8 (22.2%) with daytime hypercapnia. Twenty-six patients (72.2%) showed nocturnal hypoventilation on transcutaneous Capnometry. The sensitivity of oximetry to detect nocturnal hypoventilation was only 0.38. Twenty-eight patients (77.8%) showed sleep apnea, which was predominantly obstructive (n = 8), central (n = 9), or “mixed” (n = 11). Thirty-two patients were initiated on non-invasive ventilation which significantly improved ventilation and oxygenation in the first night of treatment. Follow-up revealed stable normoxia and normocapnia without deterioration of sleep outcomes for up to 52 months. Adherence to treatment was low to moderate, with substantial inter-individual variability. Sleep disordered breathing is highly prevalent in adult DM1 patients complaining of daytime sleepiness, and non-invasive ventilation significantly, rapidly and persistently improves nocturnal gas exchange. Capnometry is superior to oximetry for detection of nocturnal hypoventilation. Adherence to non-invasive ventilation remains a major issue in DM1, and long-term treatment benefits should be individually assessed.
Štefek Grmec - One of the best experts on this subject based on the ideXlab platform.
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Vol 13 No 6 Research Open Access
2013Co-Authors: Tadeja Hernja Rumpf, Miljenko Križmarić, Štefek GrmecAbstract:Capnometry in suspected pulmonary embolism with positive D-dimer in the fiel
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Mainz Emergency Evaluation Scoring in combination with Capnometry predicts outcome in trauma patients
Critical Care, 2012Co-Authors: Eh Hajdinjak, Štefek Grmec, Miljenko Križmarić, Et Torkar, Db Buić-rerečić, Mz Zelinka, Mš ŠkufcaAbstract:This prospective study assessed the efficacy of the predicting power for mortality of two different prehospital scoring systems in trauma patients. We present an improved Mainz Emergency Evaluation Scoring (MEES) in combination with Capnometry (MEESc). MEESc is a new scoring system. We compared the prognostic role of outcome of these two prehospital descriptive scoring systems with the prognostic scoring system APACHE II.
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Capnometry/capnography in Prehospital Cardiopulmonary Resuscitation
Anaesthesia Pharmacology Intensive Care and Emergency Medicine A.P.I.C.E., 2011Co-Authors: Štefek Grmec, K. Lah, Stefan MallyAbstract:Capnometry is a measurement of end-tidal carbon dioxide (etCO2). EtCO2 represents a partial pressure or maximal concentration of CO2 at the end of exhalation. Capnography is a measurement and a graphic display of the characteristic waveform against time or volume, known as the capnogram. CO2 reflects cellular metabolism. There are four main stages of normal CO2 physiology: production, transport, buffering and elimination. The principal determinants of etCO2 are alveolar ventilation, pulmonary perfusion (cardiac output) and CO2 production. Capnography is most commonly used during endotracheal intubation to identify correct placement of an endotracheal tube. During acutely low cardiac output, as in cardiac arrest, decreased pulmonary blood flow becomes the primary determinant resulting in abrupt decrease of partial pressure of etCO2 (petCO2). If ventilation and chest compressions are constant — with the assumption that CO2 production is uniform — then the change in petCO2 reflects the changes in systemic and pulmonary blood flow. Ultimately, it can be used as a quantitative index of evaluating adequacy of ventilation and pulmonary flow during cardiopulmonary resuscitation (CPR) [1, 2
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Capnometry capnography in prehospital cardiopulmonary resuscitation
2011Co-Authors: Štefek Grmec, K. Lah, Stefan MallyAbstract:Capnometry is a measurement of end-tidal carbon dioxide (etCO2). EtCO2 represents a partial pressure or maximal concentration of CO2 at the end of exhalation. Capnography is a measurement and a graphic display of the characteristic waveform against time or volume, known as the capnogram. CO2 reflects cellular metabolism. There are four main stages of normal CO2 physiology: production, transport, buffering and elimination. The principal determinants of etCO2 are alveolar ventilation, pulmonary perfusion (cardiac output) and CO2 production. Capnography is most commonly used during endotracheal intubation to identify correct placement of an endotracheal tube. During acutely low cardiac output, as in cardiac arrest, decreased pulmonary blood flow becomes the primary determinant resulting in abrupt decrease of partial pressure of etCO2 (petCO2). If ventilation and chest compressions are constant — with the assumption that CO2 production is uniform — then the change in petCO2 reflects the changes in systemic and pulmonary blood flow. Ultimately, it can be used as a quantitative index of evaluating adequacy of ventilation and pulmonary flow during cardiopulmonary resuscitation (CPR) [1, 2
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Combination of quantitative Capnometry, N-terminal pro-brain natriuretic peptide, and clinical assessment in differentiating acute heart failure from pulmonary disease as cause of acute dyspnea in pre-hospital emergency setting: study of diagnostic a
Croatian medical journal, 2009Co-Authors: Petra Klemen, Mirjam Golub, Štefek GrmecAbstract:Aim To determine the diagnostic accuracy of the combination of quantitative Capnometry (QC), N-terminal pro-brain natriuretic peptide (NT-proBNP), and clinical assessment in differentiating heart failure (HF)-related acute dyspnea from pulmonary-related acute dyspnea in a pre-hospital setting.
Erich Stoelben - One of the best experts on this subject based on the ideXlab platform.
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hypercapnia in copd patients undergoing endobronchial ultrasound under local anaesthesia and analgosedation a prospective controlled study using continuous transcutaneous Capnometry
Respiration, 2021Co-Authors: Thomas Galetin, Daniel Strohleit, Friederike Sophie Magnet, Jost Schnell, Aris Koryllos, Erich StoelbenAbstract:BACKGROUND Flexible bronchoscopy (FB) in analgosedation causes alveolar hypoventilation and hypercapnia, the more so if patients suffer from COPD. Nonetheless, neither is Capnometry part of standard monitoring nor is there evidence on how long patients should be monitored after sedation. OBJECTIVES We investigated the impact of COPD on hypercapnia during FB with endobronchial ultrasound (EBUS) in sedation and how the periprocedural monitoring should be adapted. METHODS Two cohorts of consecutive patients - with advanced and without COPD - with the indication for FB with EBUS-guided transbronchial needle aspiration in analgosedation received continuous transcutaneous Capnometry (ptcCO2) before, during, and for 60 min after the sedation with midazolam and alfentanil. MAIN RESULTS Forty-six patients with advanced COPD and 44 without COPD were included. The mean examination time was 26 ± 9 min. Patients with advanced COPD had a higher peak ptcCO2 (53.7 ± 7.1 vs. 46.8 ± 4.8 mm Hg, p < 0.001) and mean ptcCO2 (49.5 ± 6.8 vs. 44.0 ± 4.4 mm Hg, p < 0.001). Thirty-six percent of all patients reached the maximum hypercapnia after FB in the recovery room (8 ± 11 min). Patients with COPD needed more time to recover to normocapnia (22 ± 24 vs. 7 ± 11 min, p < 0.001). They needed a nasopharyngeal tube more often (28 vs. 11%, p < 0.001). All patients recovered from hypercapnia within 60 min after FB. No intermittent ventilation manoeuvres were needed. CONCLUSION A relevant proportion of patients reached their peak-pCO2 after the end of intervention. We recommend using Capnometry at least for patients with known COPD. Flexible EBUS in analgosedation can be safely performed in patients with advanced COPD. For patients with advanced COPD, a postprocedural observation time of 60 min was sufficient.
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Hypercapnia in COPD Patients Undergoing Endobronchial Ultrasound under Local Anaesthesia and Analgosedation: A Prospective Controlled Study Using Continuous Transcutaneous Capnometry.
Respiration; international review of thoracic diseases, 2021Co-Authors: Thomas Galetin, Daniel Strohleit, Friederike Sophie Magnet, Jost Schnell, Aris Koryllos, Erich StoelbenAbstract:Flexible bronchoscopy (FB) in analgosedation causes alveolar hypoventilation and hypercapnia, the more so if patients suffer from COPD. Nonetheless, neither is Capnometry part of standard monitoring nor is there evidence on how long patients should be monitored after sedation. We investigated the impact of COPD on hypercapnia during FB with endobronchial ultrasound (EBUS) in sedation and how the periprocedural monitoring should be adapted. Two cohorts of consecutive patients - with advanced and without COPD - with the indication for FB with EBUS-guided transbronchial needle aspiration in analgosedation received continuous transcutaneous Capnometry (ptcCO2) before, during, and for 60 min after the sedation with midazolam and alfentanil. Forty-six patients with advanced COPD and 44 without COPD were included. The mean examination time was 26 ± 9 min. Patients with advanced COPD had a higher peak ptcCO2 (53.7 ± 7.1 vs. 46.8 ± 4.8 mm Hg, p < 0.001) and mean ptcCO2 (49.5 ± 6.8 vs. 44.0 ± 4.4 mm Hg, p < 0.001). Thirty-six percent of all patients reached the maximum hypercapnia after FB in the recovery room (8 ± 11 min). Patients with COPD needed more time to recover to normocapnia (22 ± 24 vs. 7 ± 11 min, p < 0.001). They needed a nasopharyngeal tube more often (28 vs. 11%, p < 0.001). All patients recovered from hypercapnia within 60 min after FB. No intermittent ventilation manoeuvres were needed. A relevant proportion of patients reached their peak-pCO2 after the end of intervention. We recommend using Capnometry at least for patients with known COPD. Flexible EBUS in analgosedation can be safely performed in patients with advanced COPD. For patients with advanced COPD, a postprocedural observation time of 60 min was sufficient. © 2021 S. Karger AG, Basel.
