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Non-invasive Carbon Dioxide Monitoring and Endoscopic Retrograde Cholangiopancreatography Patients

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Assiut University

Keywords

Abstract

CO2 monitoring through non-invasive methods to provide an early warning of hypoventilation during procedural sedation.

Description

Many patients become hypoxic during endoscopic retrograde cholangiopancreatography (ERCP). Following induced sedation, hypoxia or hypercapnia may follow . Monitoring the CO2 level during respiration (capnography) is non-invasive, easy to do, relatively inexpensive, and has been studied extensively . End-tidal carbon dioxide is the level of CO2 released at the end of an exhaled breath . Capnography provides information about ventilation, perfusion and metabolism . Capnography devices are configured as either side stream or mainstream. Side stream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients .

The Dual guard (made in China) sets a standard in endoscopic practices; it incorporates an endoscopy bite block with oxygen delivery and CO2 monitoring for use in upper endoscopy procedures through to recovery . It improves patient safety and meets current guidelines for consciously sedated patients. The Comfort Rest Bite Block fits securely in the mouth, protecting both endoscope and patients' teeth. Simultaneous oral and nasal O2 delivery and CO2 sampling for patients undergoing upper GI endoscopy, in either a lateral or supine position. Arterial blood gas test results show the patient's acid-base balance, which is measured by the hydrogen ion concentration present in the blood, its oxygen saturation, partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), concentration of bicarbonate (HCO3), base excess and base deficit . Itcan provide information about a surgical patient's physiological state, oxygenation, ventilation and indicate the primary source of a disturbance (ie, respiratory or metabolic) in homeostasis .

Dates

Last Verified: 06/30/2020
First Submitted: 07/13/2020
Estimated Enrollment Submitted: 07/16/2020
First Posted: 07/21/2020
Last Update Submitted: 07/21/2020
Last Update Posted: 07/23/2020
Actual Study Start Date: 08/31/2020
Estimated Primary Completion Date: 08/31/2022
Estimated Study Completion Date: 09/30/2022

Condition or disease

Patient Monitoring

Intervention/treatment

Drug: propofol (2 mg/kg) and fentanyl (1ug/kg) and 4 liters O2 flow through nasal cannula

Phase

-

Eligibility Criteria

Ages Eligible for Study 20 Years To 20 Years
Sexes Eligible for StudyAll
Sampling methodNon-Probability Sample
Accepts Healthy VolunteersYes
Criteria

Inclusion Criteria:

- Adult patients aged 20-50 years.

- Males or females.

- Elective Endoscopic Retrograde Cholangiopancreatography Patients

Exclusion Criteria:

- Patient with abnormal renal function test.

- Patient with history of chronic chest disease like asthma or Chronic obstructed pulmonary diseases.

- Patients with a history of systemic illness like hypertension and diabetes.

- Cardiac patients.

Outcome

Primary Outcome Measures

1. mparison between CO2 measurement from non-invasive method (Dual guard) during conscious sedation for ERCP and invasive method (arterial blood gases). [october 2020]

mparison between CO2 measurement from non-invasive method (Dual guard) during conscious sedation for ERCP and invasive method (arterial blood gases).

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