He aha ka Capnograph?

ʻO ka capnograph kahi lāʻau lapaʻau koʻikoʻi i hoʻohana mua ʻia e loiloi i ke olakino hanu. He ana ia i ka neʻe ʻana o CO₂ i ka hanu ʻana a ua kapa ʻia ʻo ia henānā hope-tidal CO₂ (EtCO2).Hāʻawi kēia mea hana i nā ana manawa maoli me nā hōʻike nalu kiʻi (capnograms), e hāʻawi ana i nā ʻike waiwai i ke kūlana ventilatory o ka mea maʻi.

Pehea e hana ai ka Capnography?

Eia ke ʻano o ka hana ʻana i ke kino: komo ka oxygen i ke kahe koko ma o ka māmā a kākoʻo i nā kaʻina metabolic o ke kino. Ma ke ʻano he hopena o ka metabolism, hoʻopuka ʻia ka carbon dioxide, hoʻihoʻi ʻia i ka māmā, a laila hemo. ʻO ke ana ʻana i ka nui o CO₂ i loko o ka ea exhaled e hāʻawi i ka ʻike koʻikoʻi e pili ana i ka hana hanu a me ka hana metabolic o ka mea maʻi.

Pehea ka Capnograph Measures CO2？

ʻIke ʻia ka ʻōpū o ka capnograph i ka hanu ʻana ma ka hōʻike ʻana i ke kaomi ʻāpana o CO₂ ma ke ʻano nalu ma kahi pahu x- a me y-axis. Hōʻike ia i nā ʻano nalu a me nā ana helu. He helu maʻamau CO₂ (EtCO₂) hopena maʻamau mai 30 a 40 mmHg. Inā loaʻa iā EtCO ka mea maʻi2hāʻule ma lalo o 30 mmHg, hiki ke hōʻike i nā pilikia e like me ka hana ʻole o ka paipu endotracheal a i ʻole nā pilikia olakino e pili ana i ka lawe ʻana i ka oxygen.

Maʻamau (EtCO₂) _ 30 a 40 mmHg

ʻElua mau ʻano kumu mua no ke ana ʻana i ke kinoea exhaled

Mainstream EtCO2 kiaʻi

Ma kēia ʻano, hoʻokomo pololei ʻia kahi mea hoʻopili ea me kahi keʻena hoʻohālike i hoʻohui ʻia ma ke ala ea ma waena o ke kaapuni hanu a me ka paipu endotracheal.

Sidestream EtCO2Monitoring

Aia ka mea ʻike i loko o ka ʻāpana nui, kahi mamao mai ke ala ea. Hoʻomoʻa mau kekahi pamu liʻiliʻi i nā laʻana kinoea exhaled mai ka mea maʻi ma o kahi laina laʻana i ka ʻāpana nui. Hiki ke hoʻopili ʻia ka laina laʻana i kahi ʻāpana T ma ka paipu endotracheal, kahi mea hoʻopili pale anesthesia, a i ʻole pololei i ka lua ihu ma o ka sampling nasal cannula me nā nasal adapters.

ʻElua ʻano nui o nā mea nānā.

ʻO kekahi he kelepona paʻa EtCO₂ capnograph, e kālele wale ana i kēia ana.

Micro Capnometer (3)

ʻO ka mea ʻē aʻe he module EtCO₂ i hoʻohui ʻia i loko o kahi monitor multiparameter, hiki ke ana i nā ʻāpana maʻi he nui i ka manawa hoʻokahi. Hoʻokomo pinepine nā mākaʻi moe, nā lako lumi hana, a me nā defibrillators EMS i nā hiki ke ana EtCO₂.

He ahahe nā noi lapaʻau o Capnograph?

Pane ulia pōpilikia: Ke loaʻa ka maʻi i ka hopu ʻana a i ʻole ka hopu ʻana i ka naʻau, kōkua ka nānā ʻana o EtCO2 i nā limahana lapaʻau e loiloi wikiwiki i ke kūlana hanu o ka mea maʻi.
Nānā mau: No nā poʻe maʻi maʻi koʻikoʻi i ka pōʻino o ka hanu hikiwawe, hāʻawi ka nānā ʻana i ka CO₂ end-tidal hoʻomau i ka ʻikepili manawa maoli e ʻike a pane koke i nā loli.
Ke Kaʻina Hana Hoʻomāmā: Inā he ʻoki liʻiliʻi a nui paha, i ka wā e hoʻomaha ʻia ai ka mea maʻi, ʻo ka nānā ʻana o EtCO2 e hōʻoia i ka mālama ʻana o ka mea maʻi i ka ventila kūpono i loko o ke kaʻina hana.
Ka Loiloi o ka Pulmonary Function Assessment: No nā poʻe maʻi me nā maʻi maʻi e like me ka apnea hiamoe a me ka maʻi ʻōpū obstructive maʻi (COPD), kōkua nā capnographs i ka loiloi ʻana i kā lākou hana māmā.

No ke aha i manaʻo ʻia ai ka nānā ʻana o EtCO₂ he maʻamau o ka mālama?

Ua ʻike nui ʻia ʻo Capnography i kēia manawa ma ke ʻano he kūlana maikaʻi loa o ka mālama ʻana i nā hoʻonohonoho lapaʻau he nui. ʻO nā hui olakino alakaʻi a me nā kino hoʻoponopono - e like me ka American Heart Association (AHA) a me ka American Academy of Pediatrics (AAP) - ua hoʻokomo i ka capnography i kā lākou mau alakaʻi a me nā ʻōlelo aʻoaʻo. I ka hapanui o nā hihia, ua manaʻo ʻia he ʻāpana koʻikoʻi o ka nānā ʻana i ka maʻi a me ka mālama hanu.

AAAAPSF (Ahahui ʻAmelika no ka ʻae ʻia ʻana o nā ʻoihana hoʻopaʻa ʻauʻau ʻana i ka Ambulatory Plastic Surgery Facilities, Inc.)2003

“NĀ HOʻOPIʻI ANESTHESIA – pili i nā maʻi maʻi āpau… ʻO ka hoʻoheheʻe ʻana e like me ka mea i hōʻike ʻia e:…Ka nānā ʻana i ka hopena o ka tidal CO2 i hoʻopau ʻia me ka leo, Capnography/Capnometry, a i ʻole mass spectroscopy”

AAP (American Academy of Pediatrics)

Pono nā mea mālama ola e hōʻoia i ka hoʻokomo ʻana o ka paipu endotracheal ma hope koke o ka hoʻokomo ʻana, i ka wā o ka lawe ʻana a i nā manawa a pau e neʻe ai ka mea maʻi. Pono e nānā ʻia ka CO2 exhaled i nā poʻe maʻi me kahi paipu endotracheal ma mua o ka haukapila a me nā hoʻonohonoho halemai, a i ka wā o ka lawe ʻana a pau, ma o ka hoʻohana ʻana i ka colorimetric detector a capnography.

AHA (Ahahui Puuwai ʻAmelika) 2010

Nā alakaʻi alakaʻi o ka ʻAhahui Puʻuwai ʻAmelika (AHA) no ka hoʻōla ʻana i ka naʻau puʻuwai (CPR) a me ka Emer gency Cardiovascular Care (ECC) o nā maʻi Pediatric a me nā Neonatal: Nā alakaʻi alakaʻi no ka hoʻōla hou ʻana.
Mahele 8: Kākoʻo ola maʻi cardiovascular kiʻekiʻe
8.1: Nā mea hoʻohui no ka hoʻomalu ʻana i ke ala ea a me ka hoʻoheheʻe ʻana
Advanced Airways - Endotracheal Intubation Hoʻopili ʻia ka capnography waveform continuous i ka hoʻohui ʻana i ka loiloi lapaʻau ma ke ʻano he ala hilinaʻi loa no ka hōʻoia ʻana a me ka nānā ʻana i kahi kūpono o kahi paipu endotracheal (Class I, LOE A). Pono nā mea hoʻolako e nānā i ka nalu capnographic mau loa me ka ea e hōʻoia a nānā i ka hoʻokomo ʻana o ka paipu endotracheal ma ke kula, i loko o ke kaʻa lawe, i ka hōʻea ʻana i ka haukapila, a ma hope o ka hoʻololi ʻana o ka mea maʻi e hōʻemi i ka pilikia o ka ʻike ʻole ʻia ʻana o ka paipu. 'O ka ho'oku'u 'ana i ka ea supraglottic pono e loa'a i ka nalu capnograph i ka wā CPR a ma hope o ROSC (S733).

Nānā EtCO2 vs SpO2Nānā

Hoʻohālikelike ʻia me ka pulse oximetry (SpO₂),EtCO2Hāʻawi ka nānā ʻana i nā pono ʻokoʻa. No ka mea, hāʻawi ʻo EtCO₂ i ka ʻike manawa maoli i ka ea alveolar, e pane wikiwiki ana i nā loli i ke kūlana hanu. I nā hihia o ka hanu ʻana, hiki ke loli nā pae EtCO₂ kokoke koke, akā ʻo ka hāʻule ʻana o SpO₂ hiki ke lohi i kekahi mau kekona a i mau minuke. ʻO ka hoʻomau EtCO2 ka nānā ʻana e hiki ai i nā kauka ke ʻike i ka hoʻohaʻahaʻa ʻana o ka hanu ma mua, e hāʻawi ana i ka manawa alakaʻi koʻikoʻi no ka hoʻokō ʻana i ka manawa ma mua o ka emi ʻana o ka saturation oxygen.

EtCO2 kiaʻi

Hāʻawi ka nānā ʻana o EtCO2 i ka loiloi manawa maoli o ka hoʻololi kinoea hanu a me ka ea alveolar. E pane koke nā pae EtCO2 i nā mea ʻino o ka hanu a ʻaʻole i hoʻololi nui ʻia e ka oxygen hoʻohui. Ma ke ʻano he ʻano nānā ʻole-invasive, hoʻohana nui ʻia ʻo EtCO2 i nā ʻano lāʻau lapaʻau like ʻole.

Nānā Pulse Oximetry

Ka nānā ʻana i ka Pulse oximetry (SpO₂).Hoʻohana ʻo ia i kahi mea ʻike manamana lima non-invasive e ana i ke kiʻekiʻe o ka oxygen saturation o ke koko, e hiki ai ke ʻike pono i ka hypoxemia. He mea maʻalahi kēia ʻenehana a kūpono no ka nānā mau ʻana i ka ʻaoʻao moe o nā maʻi maʻi ʻole.

	Hoʻohana lāʻau lapaʻau	SpO₂	EtCO2
Mea hoʻoheheʻe mīkini	Esophageal intubation o ka paipu endotracheal	lohi	wikiwiki
	Hoʻokomo ʻia ʻo Bronchial o ka paipu endotracheal	lohi	wikiwiki
	ʻO ka hoʻopaʻa ʻana a i ʻole ka pili ʻana	lohi	wikiwiki
	Hypoventilation	x	wikiwiki
	ʻO ka hoʻokuʻu ʻana	x	wikiwiki
	Hoʻemi ʻia ke kahe o ka oxygen	wikiwiki	lohi
Mīkini Anesthesia	Ka pau ʻana o ka lime soda	lohi	wikiwiki
hoomanawanui	Haʻahaʻa hoʻoulu oxygen	wikiwiki	lohi
	Hoʻokuʻu i loko o ka puʻu	wikiwiki	lohi
	Pulmonary embolism	x	wikiwiki
	ʻO ka hyperthermia kino	wikiwiki	wikiwiki
	Hopu kaapuni	wikiwiki	wikiwiki

Pehea e koho ai i nā mea pono a me nā mea hoʻohana CO₂?

Ke hoʻomalu nei ʻo ʻAmelika ʻĀkau i ka mākeke, e helu ana ma kahi o 40% o ka loaʻa kālā o ka honua, aʻo ka ʻāina ʻo Asia-Pākīpika e manaʻo ʻia e hoʻopaʻa inoa i ka ulu wikiwiki loa, me kahi CAGR wānana o 8.3% i ka manawa like. Ke alakaʻi honuakiaʻi hoʻomanawanuinā mea hana—e like mePilipo (Respironics), Medtronic (Oridion), Masimo, a me Mindray—ke hoʻomau nei ka hana hou ʻana i ka ʻenehana EtCO2 no ka hoʻokō ʻana i nā pono e ulu nei o ka anesthesia, mālama koʻikoʻi, a me ka lāʻau lapaʻau pilikia.

No ka hoʻokō ʻana i nā koi lapaʻau a hoʻomaikaʻi i ka pono o ka holo ʻana o ka hana no nā limahana lapaʻau, ua kālele ʻo MedLinket i ka hoʻomohala ʻana a me ka hana ʻana i nā mea hoʻohana kiʻekiʻe, e like me nā laina sampling, nā mea hoʻololi ea, a me nā pahele wai. Hoʻolaʻa ʻia ka hui i ka hāʻawi ʻana i nā keʻena mālama olakino me nā hopena hoʻohana pono no ka nānā ʻana i ka mainstream a me ka sidestream, i kūpono me ka nui o nā mākaʻikaʻi mākaʻikaʻi alakaʻi, e hāʻawi ana i ka hoʻomohala ʻana i ke kahua nānā ʻana i ka hanu.

ʻO nā mea ʻike maʻamau etco2anā mea hoʻopili eaʻo ia nā mea hoʻohana maʻamau a me nā mea hoʻohana no ka nānā ʻana.

No ka nānā ʻana i ka sidestream,e noʻonoʻo e komo，sidestream sensors，amau pahele wai， CO2 Sampling laina, e pili ana i kāu hoʻonohonoho a me nā pono mālama.

Hui Pahele Wai
'OEM Mea Hana & Ho'ohālike	Kii Ref	OEM #	Kauoha Kauoha	Nā wehewehe
Mindray kūpono (Kina)
No BeneView, iPM, iMEC, PM, MEC-2000 series monitors, PM-9000/7000/6000 series, BeneHeart defibrillator		115-043022-00 (9200-10-10530)	RE-WT001A	Pahele wai maloo, makua/Pediatirc no ka module lua-slot, 10pcs / pahu
		115-043023-00 (9200-10-10574)	RE-WT001N	Pahele wai maloo, Neonatal no ka module lua-slot, 10pcs / pahu
No BeneVision, nā kiaʻi moʻo BeneView		115-043024-00 (100-000080-00)	RE-WT002A	Pahele wai Dryline II, makua/Pediatirc no ka module hoʻokahi-slot, 10pcs / pahu
		115-043025-00 (100-000081-00)	RE-WT002N	Pahele wai Dryline II, Neonatal no ka module hoʻokahi-slot, 10pcs / pahu
ʻO GE kūpono
GE Solar Sidestream EtCO₂ Module, GE MGA-1100 Mass Spectrometer GE Advantage System, EtCO₂ Sampling System		402668-008	CA20-013	Hoʻohana ka mea maʻi hoʻokahi i ka 0.8 micron Fitter, Luer Lock maʻamau, 20pcs / pahu
ʻO GE Healthcare mea hoʻolalelale, nānā, mīkini anesthesia me ka module E-miniC gas		8002174	CA20-053	ʻO ka nui o ka pahu kūloko he> 5.5mL, 25pcs / pahu
Drager kūpono
ʻO Drager Babytherm 8004/8010 Babylog VN500 ventilator kūpono		6872130	WL-01	Hoʻohana maʻi hoʻokahi Waterlock, 10pcs / pahu
Pilipo kūpono
Module kūpono:Philips - IntelliVue G5		M1657B / 989803110871	CA20-008	Pahele wai Philips, 15pcs / pahu
Pilipo kūpono			CA20-009	Paʻa paʻa wai Philips
Module kūpono:Philips – IntelliVue G7M		989803191081	WL-01	Hoʻohana maʻi hoʻokahi Waterlock, 10pcs / pahu