From the Literature: Capnography

J.S. Gravenstein; D.A. Paulus; T.J. Hayes

Editor’s note: In each APSF Newsletter, a pertinent publication from the anesthesia patient safety literature will be summarized. Suggestions for future issues are welcome.

Gravenstein J.S., Paulus D.A., Hayes T.J.: Capnography in Clinical Practice Butterworths, Stoneham, MA, 1988.

The recognition Of C02 as a significant monitoring parameter and the availability of simplified advanced technology made C02 measurement (inspired and expired) both clinically desirable and feasible. Professional organizations associated with design and implementation of patient safety standards, after demonstrating convincingly the major benefits Of C02 monitoring, became strong advocates for such measurements. This is the beginning of capnography, capnometry, or capnoscopy, as it is called by some. The bioelectronic industry, capitalizing on the opportunity, made available in a relatively short time devices to be used for this purpose in the everyday clinical practice. Unfortunately, such technological proliferation left the ordinary dini6an somewhat uninformed on this issue.

This monograph on capnography, the only current text on the subject, is a timely presentation that not only will alleviate confusion but will help the anesthesiologist better understand and utilize capnography. Capnography and capnometry, in addition to providing information concerning production and elimination Of C02, are important safety tools which, if properly used, will decrease catastrophic anesthesia accidents associated with technical misadventures with endotracheal tubes and ventilation.

The monograph addresses the issue in a rather broad spectrum. Presentation of capnography in three sections gives the reader the opportunity to direct his attention to the section pertinent to daily practice, yet allows him to refer to the physiology and technologic perspectives of capno8raphy at his leisure. The last section gives the reader a chance to formulate opinions about the performance and limitations of the functional characteristics of the devices available today. The pictures, diagrams and illustrations are clear and the references appropriate. In general, this is a very well thought out and well written monograph which undoubtedly will be a significant plus in any library associated with clinical anesthesia practice. Particularly, it will be a help for the practitioner, resident, or student seeking insight into this timely topic.

Abstracted by Israti A. Kupeli, M.D., Harvard Medical School and New England Deaconess Hospital.