End Tidal CO2

The end tidal CO2 is a measure of carbon dioxide in the blood. Its measurement determines the adequacy of ventilation, cardiac output, pulmonary perfusion, and
systemic metabolism: normal: 3545mmHg; abnormal: <35 and >45mmHg.
Hypocapnia
Cause
0
Hyperventilation
1
Endobronchial intubation, cardiovascular collapse, or pulmonary
thromboembolism
Treatment
0
Evaluate anesthetic machine or ventilator settings.
1
Evaluate tube placement.

Cause

Hypercapnia
Cause
0
Hypoventilation; inadequate ventilation
1
Anesthetic depth, interference with chest wall expansion, early
malignant hyperthermia, or equipment dead space
Treatment
0
Evaluate anesthetic depth and anesthetic machine.
1
IPPV or ventilator use.

Definition

Normal waveform
Described as one elephant
following another

Esophageal intubation
Apnea
Patient disconnect
Airway obstruction

Rebreathing of exhaled gases

Inadequate inspiratory flow
Faulty expiratory valve
Partial rebreathing circuits
Insufficient expiratory time

Hyperventilation ( in rate or
tidal volume)
Hypothermia
Vasoncontriction
Leaks in sampling system

Hypoventilation ( in rate or
tidal volume)
Exhausted soda lime

Increase of upstroke above

40mmHg

AB: baseline
BC: expiratory upstroke
CD: expiratory plateau
D: end-tidal concentration
DE: inspiration
Eventual no detection of
CO2 and lose of waveform

Increase of baseline above

zero

Gradual decrease

Partial or complete obstruction

Gradual rise without a

plateau

Airway or breathing circuit

obstruction
Large leak in breathing circuit
Disconnection
Bronchospasm
Extubation
Cardiac or respiratory arrest

Sudden drop and eventual

no detection of CO2 and lose of
waveform

2014 John Wiley & Sons, Inc. Published 2014 by John Wiley & Sons, Inc.

Graph