Abstract
Capnography waveforms and capnometry are useful perioperative monitoring tools. The paramagnetic oxygen analyzers incorporated in many clinical monitoring systems estimate oxygen concentration in the breathing circuit during various phases of ventilation. The oxygen concentration is plotted as a real-time waveform and displayed as an oxygraph. However, the clinical utility of oxygraphy is under evaluated. We are reporting four different clinical scenarios in neurosurgical patients, wherein the information yielded by oxygraphy were either not available on the capnograph or were revealed in a more promising way on the oxygraph than on the capnograph. A real-time oxygraphy waveform has four phases similar to a capnograph, although displayed in a reverse manner. Oxygraphy was useful in our patient to determine the adequacy of preoxygenation. Airway complications and unwanted neuromuscular recovery can be detected earlier by oxygraphy compared to capnography. The oxygraphy peak-to-baseline scale difference can be compressed to as low as to 6% of oxygen concentration. When the peak-to-baseline scale difference is 6 mmHg, the oxygraph becomes sensitive to even minute changes in respiratory flow characteristics. Oxygraphy may have a potential role in clinical monitoring.
We’re sorry, something doesn't seem to be working properly.
Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.
References
Heinze H, Schaaf B, Grefer J, Klotz K, Eichler W. The accuracy of the oxygen washout technique for functional residual capacity assessment during spontaneous breathing. Anesth Analg. 2007;104:598–604.
Eichler W, Schumacher J, Roth-Isigkeit A, Braun J, Kuppe H, Klotz KF. Automated evaluation of functional residual capacity by oxygen washout. J Clin Monit Comput. 2002;17:195–201.
Rosenbaum A, Kirby CW, Breen PH. By mixer system can measure O2 uptake and CO2 elimination in the anesthesia circle circuit. Can J Anaesth. 2007;54:430–40.
Butler PJ, Munro HM, Kenny MB. Preoxygenation in children using expired oxygraphy. Br J Anaesth. 1996;77:333–4.
Baraka AS, Taha SK, El-Khatib ME, Massouh FM, Jabbour DG, Alameddine MM. Oxygenation using tidal volume breathing after maximal exhalation. Anesth Analg. 2003;97:1533–5.
Baer GA, Paloheimo M, Rahnasto J, Pukander J. End-tidal oxygen concentration and pulse oximetry for monitoring oxygenation during intratracheal jet ventilation. J Clin Monit. 1995;11:373–80.
Moon RE, Camporesi EM. Respiratory monitoring. In: Miller RD, editor. Miller’s anesthesia, vol. 1. Pennsylvania: Elsevier Churchill Livingstone; 2005. p. 1437–81.
Bhavani-Shankar K, Moseley H, Kumar AY, Delph Y. Capnometry and anaesthesia. Can J Anaesth. 1992;39:617–32.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gadhinglajkar, S.V., Sreedhar, R. & Unnikrishnan, K.P. Oxygraphy: An Unexplored Perioperative Monitoring Modality. J Clin Monit Comput 23, 131–135 (2009). https://doi.org/10.1007/s10877-009-9176-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10877-009-9176-x