![]() ![]() Whereas the ABG sampling is an invasive and painful procedure for the patient which is also an expensive method and time-consuming for the medical staff, thus in this research we decided to investigate the capnography as a non-invasive method to diagnose the metabolic acidosis in suspected patients in the ED. 3 Soleimanpour et al had concluded that capnography is an appropriate tool to rule out the DKA in ED. 2 Fearon and Steele concluded that in patients with diabetic ketoacidosis (DKA), patients with ETCO2 values less than 29 suffered from DKA and the patients with ETCO2 values more than 36 did not have DKA. In a study conducted by Kartal and colleagues, they suggested that the ETCO2 level could demonstrate the severity of metabolic acidosis and mortality in these patients. These differences are caused by dead space in the respiratory system that does not participate in breathing. ![]() 6, 8 If the patient has a normal respiratory function, the difference between ETCO2 and PaCO2 was 2-5 mm Hg, and the amount of Paco2 was greater than the ETCO2. 6, 7 The Capnography provides the accurate information in terms of the ventilation, perfusion and metabolic status from one breath to the next. 3- 5 Wave capnography in a noninvasive tool and indicate the amounts of expiratory CO2. 2 In physiological conditions, the body increases the minute ventilation to compensate for the metabolic acidosis, thus PaCO2 levels would be decreased. This method sometimes causes the arterial wall spasm in some cases. The arterial blood gas (ABG) is used to evaluate the acid-base status and ABG sampling is an invasive and painful procedure for the patient, and this could lead to a delay in starting treatment by a physician. Diagnosis and appropriate treatment of the acid-base disorder could be save the patient’s life. They are usually hospitalized with the symptoms such as severe vomiting, diarrhea, weakness and lethargy, respiratory distress, renal failure, and the life-threatening acid-base disorders are also observed in some cases. The metabolic acidosis is a common problem in the emergency department (ED). The blood pH is determined by the ratio between the serum bicarbonate concentration and the PaCO2. This balance is established by the lung, kidney, and serum physiologic buffers. The natural balance of acid-base is essential for proper function of cells. R = 0.431), drug toxicity ( P < 0.001 and r = 0.856), and ketoacidosis (DKA) ( P < 0.001 and r = 0.559).Ĭonclusion: According to the results of this study, capnography can be used for primary diagnosis of metabolic acidosis in spontaneously breathing patients who referred to the emergency wards, however, the ABG must be considered as the gold standard tool for diagnosis and guiding the treatment. Level of arterial blood in patients with renal failure ( P < 0.001 and r = 0.551), sepsis ( P < 0.001 and We had 4 groups of patients with metabolicĪcidosis, also there is a significant direct linear relationship between the ETCo2 and the Hco3 In all patients, the significant direct linear relationship was foundīetween ETco2 with Hco3 (r = 0.553, P < 0.001). Results: Mean of ETco2 and Hco3 levels in patients with metabolic acidosis were 22.29 ± 4.15Īnd 12.78 ± 3.83, respectively. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. Introduction: The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. ![]()
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