NORMAL AND ABNORMAL

etCO2/CAPNOGRAPH WAVEFORMS

Normal Capnogram
The normal capnogram is a
CO2 (mmHg) etCO2: 35-45 mmHg
waveform which represents
40 D the varying CO2 level
C throughout the breath cycle.
A B E
0
15 sec.

Waveform Characteristics:
A-B: Baseline C-D: Expiratory Plateau D-E: Inspiration
B-C: Expiratory Upstroke D: End-Tidal Concentration

Bronchospasm/Asthma Other Possible Causes:

Resp Rate = 24 etCO2: >45 mmHg ∙

Bronchospasm/COPD
60
Loss of Plateau
60 ∙
Obstruction in the expiratory
limb of the breathing circuit
40 40

20 20 ∙
Presence of a foreign body in
the upper airway
15 sec. ∙
Partially kinked or occluded
artificial airway

*
Increasing etCO2 (Hypoventilation)
Other Possible Causes:
Resp Rate =8 etCO2: >45 mmHg
60 etCO2 rises gradually 60 ∙
Decrease in respiratory rate
40 40 ∙
Decrease in tidal volume
20 20 ∙
Increase in metabolic rate

15 sec.
∙
Rapid rise in body temperature
(malignant hyperthermia)

*
Decreasing etCO2 (Hyperventilation)
Resp Rate = 22 etCO2: <35 mmHg Other Possible Causes:
60 etCO2 drops gradually 60
∙
Increase in respiratory rate
40 40
∙
Increase in tidal volume
20 20
∙
Metabolic acidosis

15 sec.
∙
Fall in body temperature

Assumes adequate circulation and alveolar gas exchange

*
NORMAL AND ABNORMAL
etCO2/CAPNOGRAPH WAVEFORMS

Rebreathing CO2
Other Possible Causes:
Resp Rate = 14 etCO2: >45 mmHg
60 60 ∙
Faulty expiratory valve
40 40 ∙
Inadequate inspiratory flow
20 20 ∙
Partial rebreathing

15 sec.
Rebreathing CO2
∙
Insufficient expiratory time

Curare Cleft
Resp Rate = 16 Other Possible Causes:
etCO2: 35-45 mmHg
60
Curare Cleft
60 ∙
Patient is mechanically
ventilated
40 40

20 20 ∙
Depth of cleft is inversely
proportional to degree of
muscle relaxants
15 sec.

Cardiac Arrest
Resp Rate = 12 Other Possible Causes:
60
Rescuer Change
60 ∙
Decreased or absent cardiac
output
40 40

20 20 ∙
Decreased or absent
pulmonary blood flow
30 min. Trend Graft
∙
Sudden decrease in CO2 values

Return of Spontaneous Circulation

Resp Rate = 12 Other Possible Causes:
Successful
60 Defibrillation Return of Spontaneous Circulation
60
∙
Increase in cardiac output
40
CPR
40
∙
Increase in pulmonary blood
flow
20 20

30 min. Trend Graft

∙
Gradual increase in CO2
production

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