End-tidal kuldioxid monitorering af den ikke-intuberede, akutte patient giver potentiel diagnostisk og patientsikkerhedsmæssig værdi

Baggrund End-tidal carbondioxid (etCO2) monitorering anvendes rutinemaessigt hos alle intuberede patienter. Kapnografi er ligeledes tilgaengelig til den ikke-intuberede, akutte patient, hvor brugen i diagnostisk og patientsikkerhedsmaessigt ojemed er sparsomt beskrevet. Formal Formalet med denne statusartikel er at beskrive og diskutere eventuelle diagnostiske og patientsikkerhedsmaessige fordele og ulemper ved kapnografimonitorering af ikke-intuberede, akutte patienter. Metode Artiklen er baseret pa resultatet af en systematisk litteratursogning, hvor tilgaengelig evidens fra 1990-2016 blev identificeret fra databaserne MEDLINE, Cinahl, Scopus, Cochrane og Academic Search Complete. Litteratur relevant for denne artikels emne blev udvalgt og gennemgaet. Resultat Artiklen beskriver og diskuterer den udvalgte litteratur. Overordnet vidner denne om en diagnostisk og patientsikkerhedsmaessig fordel ved kapnografi til patienter med vejrtraekningsbesvaer, til vurdering af effekt af medicinsk behandling samt til kontinuerlig monitorering. Artiklen diskuterer ligeledes anvendelsen af kapnografi praehospitalt og potentialet for brugen i Akutafdelingen. Konklusion Kapnografi findes i varierende grad at have potentiale indenfor diagnostik og kontinuerlig monitorering af akutte patienter, efter adaekvat uddannelse i brugen. _________________________________________________________________________________________________________________________________ Background End-tidal carbon dioxide (etCO2) monitoring is routinely used in intubated patients. Capnography is also available for the non-intubated patient but its use as a diagnostic and patient safety tool is sparsely described. Aim The aim of this article was to describe and discuss potential diagnostic and patient safety benefits of capnography monitoring in acute, non-intubated patients. Methods The article is based on the results of a systematic literature search, where available evidence from 1990-2016 was located from the databases MEDLINE, Cinahl, Scopus, Cochrane and Academic Search Complete. Literature relevant for this article was selected and reviewed. Results The article describes and discusses the selected literature. Overall, there is evidence of a diagnostic and patient safety benefit for patients with breathing difficulties, assessment of the effect of medical treatment and capnography used as continuous monitoring. The article further discusses the prehospital use of capnography in Denmark and the possible advantages for its use in the Emergency Department. Conclusions After adequate training in its use, capnography seems to have potential in diagnostics and continuous monitoring of acute, non-intubated patients.