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Normal and abnormal capnography

waveforms infographic
 OCTOBER 3RD, 2018 PDCAPNOGRAPHY  TRAINING RESOURCES

NORMAL AND ABNORMAL etCO2/CAPNOGRAPH WAVEFORMS

Normal Capnogram CO2 (mmHg) etCO2: 35-45 mmHg Rebreathing CO2 Resp Rate = 14 etCO2: >45 mmHg

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The normal capnogram is a waveform which Other Possible Causes: 60 60

represents the varying CO2 level throughout 40 D

C • Faulty expiratory valve 40 40
the breath cycle.
• Inadequate inspiratory ow 20 20
A B E Rebreathing CO 2
Waveform Characteristics: 0 • Partial rebreathing
A-B: Baseline D: End-Tidal Concentration 15 sec. • Insucient expiratory time 15 sec.
B-C: Expiratory Upstroke D-E: Inspiration
C-D: ExpiratoryPlateau

Bronchospasm/Asthma Resp Rate = 24 etCO2: >45 mmHg Curare Cleft Resp Rate = 16 etCO2: 35-45 mmHg
Other Possible Causes:
• Bronchospasm/COPD
• Obstruction in the expiratory limb of the
60

40

20
Loss of Plateau
60

40

20
Other Possible Causes:
• Patient is mechanically ventilated
• Depth of cleft is proportional to
‫ٮٮ"ﺎ‬$ ‫ﻠ‬$‫ﻛٮ"ﺎﻛٮ‬ 60

40

20
Curare Cleft
60

40

20
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breathing circuit degree of muscle relaxants
• Presence of a foreign body in the upper airway 15 sec. 15 sec.
• Partially kinked or occluded artifcial airway

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*Increasing etCO2 (Hypoventilation) Resp Rate =8 etCO2: >45 mmHg Cardiac Arrest Resp Rate = 12

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60 etCO2 rises gradually 60 60 60
Other Possible Causes: Other Possible Causes:
Rescuer Change
• Decrease in respiratory rate 40 40 • Decreased or absent cardiac output 40 40

• Decrease in tidal volume 20 20 • Decreased or absent pulmonary 20 20

• Increase in metabolic rate blood ow

• Rapid rise in body temperature 15 sec. • Sudden decrease in CO2 values 30 min. Trend Graft
(malignanthyperthermia)

*Decreasing etCO2 (Hyperventilation) Resp Rate = 22 etCO2: <35 mmHg Return of Spontaneous Resp Rate = 12
Successful
Returnof SpontaneousCirculation
Other Possible Causes:
60 etCO2 drops gradually 60
Circulation 60 Defbrillation 60

• Increase in respiratory rate 40 40

Other Possible Causes:
40 40

CPR
• Increase in tidal volume 20 20
• Increase in cardiac output 20 20

• Metabolic acidosis • Increase in pulmonary blood ow

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• Fall in body temperature 15 sec. 30 min. Trend Graft
• Gradual increase in CO2 production

Preoxygenation matters:
*Assumes adequate circulation and alveolar gas exchange

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