Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial
BackgroundUse of capnography as a non-invasive method during the weaning process for fast track extubation (FTE) is controversial. We conducted the present study to determine whether pulse oximetry and capnography could be utilized as alternatives to arterial blood gas (ABG) measurements in patients...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.826761/full |
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| author | Seyed Tayeb Moradian Fatemah Beitollahi Mohammad Saeid Ghiasi Amir Vahedian-Azimi |
| author_facet | Seyed Tayeb Moradian Fatemah Beitollahi Mohammad Saeid Ghiasi Amir Vahedian-Azimi |
| author_sort | Seyed Tayeb Moradian |
| collection | DOAJ |
| description | BackgroundUse of capnography as a non-invasive method during the weaning process for fast track extubation (FTE) is controversial. We conducted the present study to determine whether pulse oximetry and capnography could be utilized as alternatives to arterial blood gas (ABG) measurements in patients under mechanical ventilation (MV) following coronary artery bypass graft (CABG) surgery.MethodsIn this randomized clinical trial, 70 patients, who were candidates for CABG surgery, were randomly assigned into two equal groups (n = 35), intervention and control group. In the intervention group, the ventilator management and weaning from MV was done using Etco2 from capnography and SpO2 from pulse oximetry. Meanwhile, in the control group, weaning was done based on ABG analysis. The length of intensive care unit (ICU) stay, time to extubation, number of manual ventilators setting changes, and alarms were compared between the groups.ResultsThe end-tidal carbon dioxide (ETCO2) levels in the intervention group were completely similar to the partial pressure of carbon dioxide (PaCo2) in the control group (39.5 ± 3.1 vs. 39.4 ± 4.32, p > 0.05). The mean extubation times were significantly shorter in the intervention group compared to those in the control patients (212.2 ± 80.6 vs. 342.7 ± 110.7, p < 0.001). Moreover, the number of changes in the manual ventilator setting and the number of alarms were significantly lower in the intervention group. However, the differences in the length of stay in ICU between the two groups were not significant (p = 0.219).ConclusionOur results suggests that capnography can be used as an alternative to ABG. Furthermore, it is a safe and valuable monitor that could be a good alternative for ABG in this population. Further studies with larger sample sizes and on different disease states and populations are required to assess the accuracy of our findings.Clinical Trial RegistrationCurrent Controlled Trials, IRCT, IRCT201701016778N6, Registered 3 March 2017, https://www.irct.ir/trial/7192. |
| first_indexed | 2024-12-12T04:45:55Z |
| format | Article |
| id | doaj.art-b7b50dd5374247e29c2b8f0637bdf375 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-12T04:45:55Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-b7b50dd5374247e29c2b8f0637bdf3752022-12-22T00:37:38ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-05-01910.3389/fsurg.2022.826761826761Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical TrialSeyed Tayeb Moradian0Fatemah Beitollahi1Mohammad Saeid Ghiasi2Amir Vahedian-Azimi3Atherosclerosis Research Center, Nursing Faculty, Baqiyatallah university of Medical Sciences, Tehran, IranAtherosclerosis Research Center, Nursing Faculty, Baqiyatallah university of Medical Sciences, Tehran, IranAtherosclerosis Research Center, Medicine Faculty, Baqiyatallah University of Medical Sciences, Tehran, IranTrauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IranBackgroundUse of capnography as a non-invasive method during the weaning process for fast track extubation (FTE) is controversial. We conducted the present study to determine whether pulse oximetry and capnography could be utilized as alternatives to arterial blood gas (ABG) measurements in patients under mechanical ventilation (MV) following coronary artery bypass graft (CABG) surgery.MethodsIn this randomized clinical trial, 70 patients, who were candidates for CABG surgery, were randomly assigned into two equal groups (n = 35), intervention and control group. In the intervention group, the ventilator management and weaning from MV was done using Etco2 from capnography and SpO2 from pulse oximetry. Meanwhile, in the control group, weaning was done based on ABG analysis. The length of intensive care unit (ICU) stay, time to extubation, number of manual ventilators setting changes, and alarms were compared between the groups.ResultsThe end-tidal carbon dioxide (ETCO2) levels in the intervention group were completely similar to the partial pressure of carbon dioxide (PaCo2) in the control group (39.5 ± 3.1 vs. 39.4 ± 4.32, p > 0.05). The mean extubation times were significantly shorter in the intervention group compared to those in the control patients (212.2 ± 80.6 vs. 342.7 ± 110.7, p < 0.001). Moreover, the number of changes in the manual ventilator setting and the number of alarms were significantly lower in the intervention group. However, the differences in the length of stay in ICU between the two groups were not significant (p = 0.219).ConclusionOur results suggests that capnography can be used as an alternative to ABG. Furthermore, it is a safe and valuable monitor that could be a good alternative for ABG in this population. Further studies with larger sample sizes and on different disease states and populations are required to assess the accuracy of our findings.Clinical Trial RegistrationCurrent Controlled Trials, IRCT, IRCT201701016778N6, Registered 3 March 2017, https://www.irct.ir/trial/7192.https://www.frontiersin.org/articles/10.3389/fsurg.2022.826761/fullairway extubationcoronary artery bypasscapnographyblood gas analysispulse oximetry |
| spellingShingle | Seyed Tayeb Moradian Fatemah Beitollahi Mohammad Saeid Ghiasi Amir Vahedian-Azimi Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial Frontiers in Surgery airway extubation coronary artery bypass capnography blood gas analysis pulse oximetry |
| title | Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial |
| title_full | Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial |
| title_fullStr | Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial |
| title_full_unstemmed | Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial |
| title_short | Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial |
| title_sort | capnography and pulse oximetry improve fast track extubation in patients undergoing coronary artery bypass graft surgery a randomized clinical trial |
| topic | airway extubation coronary artery bypass capnography blood gas analysis pulse oximetry |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.826761/full |
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