呼吸末CO2监测（新英格兰杂志）
http://player.youku.com/player.php/sid/XNDgwMTg4MzAw==.html通过记录病人呼出气体中的CO2状况，医生可据此了解病人的代谢、血液循环和呼吸情况。当无法测出CO2时，提示病人已出现多系统的受损。NEJM的这段临床教学视频对呼吸末CO2监测的适应症，操作细节和并发症等进行了详细描述，推荐学习！
Monitoring Ventilation with Capnography
Rafael Ortega, M.D., Christopher Connor, M.D., Ph.D., Sora Kim, B.S., Robin Djang, M.A., and Kunal Patel, M.D.
N Engl J Med 2012; 367:e27November 8, 2012DOI: 10.1056/NEJMvcm1105237
Share:Dr. Ortega reports holding stock in Anesthesia Associates of Massachusetts and the Plexus Management Group, and Dr. Connor reports that his employer has filed a patent application regarding the systems and methods used for the secure transmission of clinical data. No other potential conflict of interest relevant to this article was reported. 英语差了 听不明白 得加强学习啊 楼主，新英格兰上的video一般都配有PDF 的讲解版本的，可否一起上传，好更好学习！ 召唤字幕组，实在听不懂啊。。。 听不懂有字幕就好了 我很想问：高峰代表得是吸气还是呼气？？？请赐教 回复 6# jiale
代表呼气，峰值即为ETCO2 回复 6# jiale
高峰代表呼气末，吸气的开始。 听了很受启发，下面就本人听到的英语，作一下记录，有不妥之处肯请同行指导正。 this is includical video from the journal of new england.
overview :carbin dioxide is generateded in the body as a metabotic by-product.carbin dioxide is dissolved in the blood and is transported in the blood stream until it reachs the lung where it diffuse into is ventilated through opening trochobronchia tree and patent upper airway.carbin dioxide then can be detected in the patients expirated breath. the measurement of expirated carbin dioxide provide an insight ofimportant life sustaining process that include the metabotic ,respiratory and circutory activative .capnography is a standard of care monitoring adequency of ventilation in the patient recieving anesthesia ,it is also used to monitor ventilation during the procedure that porformed while patient is undrgone moderate or deeper sedation capnography is increasely use to monitor patients who are recieving mechanical ventilation in an intensive unite and to aid in assessement and treatment of cardiac arrest .before capnography is avaliable ,physistes relyed on physical exame such as auscautation of chest to assess the adequency of ventilation and proper placement of endointubation and artertary gas analysis to determine partial blood pressure of carbin dioxide .capnogragraphy allows noninvasive and continuious monitor the level of carbin dioxide and provide valueble information reguarding as metabotic , respiratoryand circulatory cindition of patient, although capnography is not complicated ,clinisist must understand the preciple of capnography and how it works in order to intepret the informamation it provides
definition :capnometry refers to measurement and new metrical display of carbin dioxide concentration, capnography refers to display exhaled and inhaled concentration of carbin dioxide applied at the time.colour metrynography is a qualitated method determining the presence of carbin dioxide using PH sensitive filter that changes the colour from purple to yellow when co2 is detected .
terminology :Paco2 denotes the partial pressure of artarial carbin dioxide end tidal carbin dioxide (EPco2) is the percentage of concentration or partail pressure of carbin dioxide at the end of exhalation .normaly five percentage of atmosphere pressure approximately 38% millimeter of mercury at sea level .hypercapnia andhypercarbia refer to greater than normal partialpressure of carbin dioxide inblood ;.hypocapnia andhypocarbiarefer to lower than partial pressure .
indication:capnography is used in the operating room to aid in proper placement of endointubation and to monitor ventilation.capnography is increasely used in assess the adequency of ventilation and to monitor hypercapnia or hypocapnia in the treatment area such as intensive unite ,postanesthesia unite ,emergency department and ambulance; endoscopy suite ;sleep labortary;cardiac catherization labortary .carbin dioxide detection is frequently used in cardiac pulmonary resuscitation to aid in proper placement of endointubtation and to assess effectiveness of resuscitation effort while pulsometeryis a good method to assess ofoxygenation .capnography provides more direct information of patients ventilation status. capnography is particularly helpful in the patients who are recieving submental oxygenation during which a normal hemoglobe saturation can be presented inspiteto marred type of ventilation.
contraindication : 感谢bird111的帮助，很不错，晚一点我来整理一下，发出来。
都是在您的帮助下。
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