Place de la surveillance de la capnographie dans les détresses respiratoires aiguës

Monitoring end tidal carbon dioxide values (ETCO2) with non-invasive capnography is a routine procedure in anaesthesia, intensive care and emergency medicine. Although controversy persists on whether patients with acute respiratory distress should be monitored with capnography, this technique can confirm endotracheal intubation and integrity of ventilatory apparatus, direct towards a diagnosis and in some situations, guide therapeutic. However, capnography does not allow to be freed from the measurement of arterial carbon dioxide pressure (PaCO2) because many cardiopulmonary diseases increase the difference between PaCO2 and ETCO2. The PaCO2-ETCO2 gradient must be initially calculated and then re-evaluated to avoid erroneous interpretations. The evolution of this gradient can be used as an effective clinical tool to evaluate the effect of therapeutic and the adequacy of the ventilatory parameters.