NORMAL AND ABNORMAL etCO2/CAPNOGRAPH WAVEFORMS

Normal Capnogram
CO2 (mmHg) etCO2: 35-45
mmHg Rebreathing CO2 Resp Rate = 14
etCO2: >45 mmHg
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 flow 20

20

A B E
Rebreathing CO2
Waveform Characteristics:
0
Partial rebreathing
A-B: Baseline D: #End-Tidal Concentration
15 sec. Insufficient
expiratory time 15 sec.
B-C: Expiratory Upstroke D-E: Inspiration
C-D: Expiratory Plateau

Bronchospasm/Asthma
Resp Rate = 24

Loss of Plateau

etCO2: >45 mmHg Curare Cleft Resp Rate

= 16 etCO2: 35-45 mmHg

Curare Cleft

60 60
Other Possible Causes:
Other Possible Causes: 60
60

Bronchospasm/COPD
40 40
Patient is mechanically ventilated 40
40

Obstruction in the expiratory limb of the

20 20
Depth of cleft is proportional to 20
20
breathing circuit
degree of muscle relaxants
Presence of a foreign body in the upper airway
15 sec.
15 sec.
Partially kinked or occluded artificial airway

*#Increasing etCO2 (Hypoventilation)

Resp Rate =8 etCO2: >45
mmHg Cardiac Arrest Resp Rate = 12

60 etCO2 rises gradually 60

Other Possible Causes:
Other Possible Causes: 60
60

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 flow
Rapid rise in body temperature
15 sec. Sudden decrease
in CO2 values 30 min. Trend Graft
(malignant hyperthermia)

*Decreasing etCO2 (Hyperventilation)

Resp Rate = 22 etCO2: <35
mmHg Return of Spontaneous Resp Rate = 12

Successful

Return of Spontaneous Circulation

Other Possible Causes:
60 etCO2 drops gradually 60

Circulation 60 Defibrillation
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 flow
Fall in body temperature
15 sec.
30 min. Trend Graft

Gradual increase in CO2 production

*Assumes adequate circulation and alveolar gas exchange

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