Respiratory compromise — incidents of respiratory insufficiency, failure, and arrest — is a genuine threat to patients and health systems.1 A 2016 analysis of 44,551 acute respiratory events revealed a mortality rate of 39.4%.1 Another analysis expects cases of respiratory compromise to increase 31% by 2019.2
Those trends must be reversed — and they can be.
Because addressing respiratory compromise begins with detecting it. And that’s what capnography is engineered to help clinicians do.
Continuous monitoring of oxygenation and ventilation are two key factors used to identify respiratory compromise in its early stages. With Microstream™ technology, you can measure both, so you can focus on what you do best: help save lives.3–6
Capnography is the noninvasive continuous measurement of CO2 concentration over time. It provides numerical etCO2 data and graphic waveforms showing CO2 levels. Use this quick and free tool to gain an in-depth understanding of changes in the capnography waveform.
take the tutorialMicrostream™ capnography monitoring is accurate and easy-to-use — across many areas of care. It provides clinicians with a real-time alert to respiratory compromise, so they can intervene early and save lives.
The use of continuous capnography monitoring in many areas of care is recommended by a growing wave of clinical societies:
The American Heart Association (AHA) calls for capnography monitoring to help clinicians monitor quality of chest compressions, to confirm endotracheal tube placement, and to use as an early indicator of the return of spontaneous circulation (ROSC).8,9
The Association for Radiologic and Imaging Nursing (ARIN) endorses the routine use of capnography for all patients who receive moderate sedation or analgesia during procedures in the imaging environment.10
The American Society of Anesthesiologists (ASA) recommends supplementing visual monitoring with the use of pulse oximetry and capnography for patients under moderate to deep sedation.11
The Anesthesia Patient Safety Foundation (APSF) recommends continuous monitoring of oxygenation and ventilation to help reduce the likelihood of unrecognized, clinically significant opioid-induced respiratory depression.12
Nearly 50% of monitored anesthesia care (MAC) claims are related to respiratory depression and are preventable by better monitoring, including capnography, improved vigilance, or audible alarms.13
In procedural sedation, 97% of respiratory claims could have been avoided with better patient monitoring and response.14
Ray Maddox, Pharm. D., has coauthored several papers that describe the results of capnography monitoring implementation at the St. Joseph’s/Candler Health System in Savannah, Georgia.
Watch a short video to learn what Dr. Maddox has to say about the economic impact of reducing adverse events. In the interview, Dr. Maddox explains that in five years, the facility experienced an internal rate of return of 83%, with a cost savings of $1.8 million above the cost of the capnography technology. And he feels capnography helped save lives.15
See More About RC Prevention >
Microstream™ technology measures end-tidal CO2, respiration rate, and apnea more accurately and reliably than other technologies and sampling lines.16–18† That’s because it’s engineered to deliver:17†
Effective sampling from both nares and the mouth — even at low tidal volumes — with the Smart CapnoLine™ Plus sampling line with exclusive Uni-junction™ technology
Highly accurate etCO2 samples that are unaffected by the presence of other gases (i.e., O2, N20, He, or inhaled anesthetics) due to unique CO2-specific IR wavelength molecular correlation spectroscopy technology
Provides a complete measurement of a patient’s oxygenation and ventilation status
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Delivers continuous, noninvasive, real-time respiratory status monitoring of etCO2, SpO2, respiration rate, and pulse rate
See It Work
A portfolio of etCO2 sampling lines designed for use with Microstream™-enabled monitors for both intubated and nonintubated patients, neonate to adult
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Algorithms like the SARA™ algorithm are engineered to reduce insignificant or ‘nuisance’ alarms by 53%18
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Troubleshooting experts
Microstream™ technology is designed with you — and your patients — in mind. Capnography monitoring offers:
Early detection
Accuracy
Ease of use
And that safety has been provided, in part, by the Smart Capnography™ family of algorithms. They simplify the use of Microstream™ capnography monitoring by ensuring there’s minimal disruption to your clinical workflow.
The Smart Capnography™ family of algorithms includes the Smart Alarm for Respiratory Analysis™ algorithm (SARA) and the Integrated Pulmonary Index™ algorithm (IPI):
The SARA algorithm is engineered to reduce insignificant or “nuisance” alarms by 53%.18
IPI combines four real-time measures — etCO2, SpO2, respiratory rate, and pulse rate — to provide an inclusive assessment of a patient’s respiratory status in a single number.
Now you and your team can always keep an eye on your patients. With the combination of the VitalSync™ virtual patient monitoring platform and Microstream™ capnography.
This integrated software platform can help you:
Make timely, well-informed clinical decisions based on near real-time data at breath-to-breath, heartbeat-to-heartbeat resolution
Implement and automate proven clinical protocols using CDS apps
View patient information remotely and receive updates and alerts on any web-enabled device
VitalSync™ virtual patient monitoring platform and Microstream™ capnography. Together, they can help you keep your patient safe — wherever you are.
Explore the Power of Vital Sync™ Remote Monitoring
We’re committed to partnering with you to overcome clinical and economic challenges. And part of that commitment includes industry-leading advancements like Microstream™ technology. Routine use of capnography monitoring may:
Reduce the cost per gastrointestinal endoscopy procedure by $8520
Generate an average annual cost avoidance of $304,23420
Help avoid a cost of around $53,502 per episode of respiratory failure, according to HealthGrades estimates21
Capnography monitoring can help you continue to save lives and reduce costs by mitigating respiratory adverse events.21
Contact your local Medtronic sales representative to:
Better understand your needs: review your current etCO2 monitoring demands
Improve value: assess — at no charge — how Microstream™ technology solutions are designed to help you improve clinical and economic value
Find the best solution: learn how Microstream™ technology can be tailored to your patient safety and monitoring needs
1. Andersen LW, Berg KM, Chase M., et al. Acute respiratory compromise on inpatient wards in the United States: Incidence, outcomes, and factors associated with in-hospital mortality. Resuscitation. 2016;105:123–129.
2. Agarwal SJ, Erslon MG, Bloom JD. Projected incidence and cost of respiratory failure, insufficiency and arrest in Medicare population, 2019. Abstract presented at: Academy Health Congress; June 2011; Seattle.
3. Metzner J, Posner KL, Domino KB. The risk and safety of anesthesia at remote locations: the US closed claims analysis. Curr Opin Anaesthesiol. 2009;22(4):502–508.
4. Cook TM, Woodall N, Harper J, Benger J; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments. Br J Anaesth. 2011;106(5):632–642.
5. Patail B. Veterans Health Administration. In: Infusing Patients Safely: Priority Issues from the AAMI/FDA Infusion Device Summit. Oct. 5, 2010:12.
6. McCarter T, Shaik Z, Scarfo K, Thompson LJ. Capnography monitoring enhances safety of postoperative patient-controlled analgesia. Am Health Drug Benefits. 2008;1(5):28–35.
7. The Joint Commission Sentinel Event Alert. Safe use of opioids in hospitals. Issue 49. Aug. 8, 2012.
8. Field JM, Hazinski MF, Sayre MR, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 suppl 3):S640 –S656.
9. Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: adult advanced cardiovascular life support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 suppl 2):S444–S464.
10. Brast S, Bland E, Jones-Hooker C, et al. Capnography for the Radiology & Imaging Nursing: A Primer. J Radiol Nurs. 2016;35:173–190.
11. Committee of Origin: Standards and Practice Parameters. Standards for Basic Anesthetic Monitoring. American Society of Anesthesiologists Website. https://www.asahq.org/~/media/Sites/ASAHQ/Files/Public/Resources/standards-guidelines/standards-for-basic-anesthetic-monitoring.pdf. Last affirmed on October 28, 2015. Accessed Oct. 31, 2017.
12. Stoelting RK, Overdyke FJ. Essential Monitoring Strategies to Detect Clinically Significant Drug Induced Respiratory Depression in the Postoperative Period Conclusions and Recommendations. Updated Sept. 26, 2015. https://www.apsf.org/newsletters/pdf/fall_2011.pdf. Accessed Dec. 7, 2017.
13. Bhananker SM, Posner KL, Cheney FW, Caplan RA, Lee LA, Domino KB. Injury and liability associated with monitored anesthesia care: a closed claims analysis. Anesthesiology. 2006;104(2):228–234.
14. Lee LA, Caplan RA, Stephens LS, et al. Postoperative opioid-induced respiratory depression: a closed claims analysis. Anesthesiology. 2015;122(3):659–665.
15. Maddox R. Personal interview. http://www.rtmagazine.com/2012/07/respiratory-care-departments-take-a-lead-role-in-postoperative-monitoring/. Accessed 12/6/2017.
16. Maddox RR, Williams CK, Oglesby H, Butler B, Colclasure B. Clinical experience with patient-controlled analgesia using continuous respiratory monitoring and a smart infusion system. Am J Health Syst Pharm. 2006;63(2):157–164.
17. Colman Y, David U. Comparison of Capnography Filter Lines for Nose and Mouth Breathing of End Tidal Carbon Dioxide Sampling With and Without Supplemental Oxygen. STA Annual Meeting Abstracts; January 2009.
18. Hockman S, Glembot T, Niebel K. Comparison of capnography derived respiratory rate alarm frequency using the SARA algorithm versus an established non-adaptive respiratory rate alarm management algorithm in bariatric surgical patients. Resp Care. 2009 Open Forum Abstract; December 2009.
19. Based on Microstream™ Sampling Lines Sales Tracings from 1995 to 2017 Report. Analyzed 7 August 2017.
20. Saunders R, Erslon M, Vargo J. Modeling the costs and benefits of capnography monitoring during procedural sedation for gastrointestinal endoscopy. Endosc Int Open. 2016;4(3):E340–51.
21. Jopling M, Heard L, Kofol T, Warner E. Evaluating the cost-effectiveness of capnography monitoring in procedural sedation: a gastroenterology (GI) suite cost-avoidance model. Gastrointestinal Endoscopy. 2015;81(5S):AB193. Health Grades Patient Safety in American Hospitals Study. March 2011. Available at http://patientsafetymovement.org/wp-content/uploads/2016/02/Resources_Reports_Patient_Safety_in_American_Hospitals_Study.pdf.