He aha ka Capnograph？

He mea lapaʻau koʻikoʻi ka capnograph i hoʻohana nui ʻia no ka loiloi ʻana i ke olakino hanu. Ana ia i ka nui o CO₂ i ka hanu i hoʻokuʻu ʻia a ua kapa pinepine ʻia ʻo ia heka mea nānā i ka CO₂ hope-kai (EtCO2).Hāʻawi kēia hāmeʻa i nā ana manawa maoli me nā hōʻikeʻike nalu kiʻi (capnograms), e hāʻawi ana i nā ʻike waiwai i ke kūlana hanu o ka mea maʻi.

Pehea e hana ai ke kāpnografia?

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

Pehea e ana ai kahi Capnograph i ke CO2ʻAʻole anei?

Hoʻohana kahi monitor capnograph e ana i ka hanu i hoʻokuʻu ʻia ma ka hōʻike ʻana i ke kaomi hapa o CO₂ ma ke ʻano nalu ma kahi grid x- a me y-axis. Hōʻike ia i nā ʻano nalu a me nā ana helu. ʻO ka heluhelu ʻana o ka CO₂ tidal hope (EtCO₂) maʻamau mai 35 a 45mmHg. Inā ʻo ka EtCO o ka mea maʻi2Inā hāʻule ka paʻakai ma lalo o 30 mmHg, hiki iā ia ke hōʻike i nā pilikia e like me ka hana hewa ʻana o ka ʻōmole endotracheal a i ʻole nā pilikia olakino ʻē aʻe e hoʻopilikia ai i ka lawe ʻana o ka oxygen.

ʻElua mau ʻano hana nui no ke ana ʻana o ke kinoea i hoʻokuʻu ʻia

Ka Nānā ʻana i ka EtCO2 Mainstream

Ma kēia ʻano hana, ua kau pololei ʻia kahi mea hoʻololi ea me kahi keʻena laʻana i hoʻohui ʻia i loko o ke ala ea ma waena o ke kaapuni hanu a me ka ʻōmole endotracheal.

Nānā ʻana o Sidestream EtCO2

Aia ka mea ʻike i loko o ka ʻāpana nui, ma kahi mamao aku o ke ala ea. Hoʻopuka mau kahi pamu liʻiliʻi i nā hāpana kinoea i hoʻokuʻu ʻia mai ka mea maʻi ma o kahi laina laʻana i ka ʻāpana nui. Hiki ke hoʻopili ʻia ke laina laʻana i kahi ʻāpana T ma ka ʻōmole endotracheal, kahi mea hoʻololi mask anesthesia, a i ʻole pololei i ka lua ihu ma o kahi cannula ihu laʻana me nā mea hoʻololi ihu.

Aia kekahi ʻelua ʻano nui o nā monitor.

ʻO kekahi he capnograph EtCO₂ i hoʻolaʻa ʻia no ka lawe lima, e kālele wale ana i kēia ana.

Kapnometer liʻiliʻi (3)

ʻO kekahi he module EtCO₂ i hoʻohui ʻia i loko o kahi monitor multiparameter, hiki ke ana i nā ʻano maʻi he nui i ka manawa hoʻokahi. Hoʻokomo pinepine nā monitor ʻaoʻao moe, nā lako lumi hana, a me nā defibrillators EMS i nā hiki ke ana ʻo EtCO₂.

He ahaʻo nā noi lapaʻau o Capnograph?

Pane PilikiaKe loaʻa nei i ka mea maʻi ka hopu ʻana o ka hanu a i ʻole ka hopu ʻana o ka puʻuwai, kōkua ka nānā ʻana iā EtCO2 i nā limahana lapaʻau e loiloi koke i ke kūlana hanu o ka mea maʻi.
Ka Nānā Mau ʻanaNo nā poʻe maʻi koʻikoʻi i ka pilikia o ka hōʻemi koke ʻana o ka hanu, hāʻawi ka nānā ʻana i ka CO₂ hope-tidal i ka ʻikepili manawa maoli e ʻike a pane koke i nā loli.
Kaʻina Hana HoʻomahaInā he ʻoki kino liʻiliʻi a nui paha, i ka wā e hoʻomaha ʻia ai ka mea maʻi, hōʻoia ka nānā ʻana iā EtCO2 e mālama ka mea maʻi i ka ea kūpono i loko o ke kaʻina hana.
Loiloi Hana PulmonaryNo nā poʻe maʻi me nā maʻi maʻi e like me ka apnea hiamoe a me ka maʻi pulmonary obstructive mau loa (COPD), kōkua nā capnographs i ka loiloi ʻana i ka hana o kā lākou māmā.

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

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

AAAAPSF (ʻAhahui ʻAmelika no ka Hōʻoia ʻana o nā Hale Hana ʻoki Plastic Ambulatory, Inc.)2003

"KA NĀNĀ ʻANA I KA ANESTHESIA - pili i nā anesthesia āpau ... Ea ea e like me ka mea i ʻōlelo ʻia e: ... Ka nānā ʻana i ka CO2 i hoʻopau ʻia me ka nui, Capnography / Capnometry, a i ʻole ka spectroscopy mass"

AAP (ʻAhahui ʻAmelika o nā Pediatrics)

Pono nā mea mālama ola e hōʻoia i ke kau ʻana o ka paipu endotracheal ma hope koke iho o ka intubation, i ka wā e lawe ʻia ai a i ka wā e neʻe ʻia ai ka mea maʻi. Pono e nānā ʻia ka CO2 i hoʻokuʻu ʻia i loko o nā mea maʻi me kahi paipu endotracheal ma nā wahi hoʻonohonoho pre-hospital a me ka haukapila, a me ka wā e lawe ʻia ai, ma ka hoʻohana ʻana i kahi mea ʻike colorimetric a i ʻole capnography.

AHA (ʻAhahui Puʻuwai ʻAmelika) 2010

Nā Alakaʻi o ka ʻAhahui Puʻuwai ʻAmelika (AHA) no ka Hoʻōla ʻana i ka Cardiopulmonary (CPR) a me ka Mālama Cardiovascular Pōpilikia (ECC) o nā maʻi Pediatric a me Neonatal: Nā Alakaʻi Hoʻōla ʻana i ka Neonatal
Māhele 8: Kākoʻo Ola Cardiovascular Kiʻekiʻe no nā Mākua
8.1: Nā mea kōkua no ka Mana Alanui a me ka Hoʻoulu ʻana i ka Ea
ʻO Advanced Airways - Endotracheal Intubation Manaʻo ʻia ka capnography waveform continuous ma waho aʻe o ka loiloi lapaʻau ma ke ʻano he ala hilinaʻi loa no ka hōʻoia ʻana a me ka nānā ʻana i ke kau pololei ʻana o kahi paipu endotracheal (Class I, LOE A). Pono nā mea lawelawe e nānā i kahi waveform capnographic mau me ka ea e hōʻoia a nānā i ke kau ʻana o ka paipu endotracheal ma ke kahua, i loko o ke kaʻa lawe, i ka hōʻea ʻana i ka haukapila, a ma hope o kekahi hoʻoili ʻana o ka mea maʻi e hōʻemi i ka pilikia o ka hewa ʻana o ka paipu a i ʻole ka neʻe ʻana. Pono ka ea maikaʻi ma o kahi hāmeʻa ea supraglottic e hopena i kahi waveform capnograph i ka wā CPR a ma hope o ROSC (S733).

Nānā ʻana iā EtCO2 vs SpO2Nānā ʻana

Ke hoʻohālikelike ʻia me ka pulse oximetry (SpO₂),ʻO EtCO2Hāʻawi ka nānā ʻana i nā pono ʻokoʻa. No ka mea, hāʻawi ʻo EtCO₂ i ka ʻike manawa maoli i ka ea alveolar, pane wikiwiki ia i nā loli i ke kūlana hanu. I nā hihia o ka pilikia o ka hanu, loli koke nā pae EtCO₂, ʻoiai ʻo ka hāʻule ʻana o SpO₂ e lohi paha i kekahi mau kekona a i mau minuke. ʻO ka nānā mau ʻana o EtCO2 e hiki ai i nā kauka ke ʻike mua i ka hōʻino ʻana o ka hanu, e hāʻawi ana i ka manawa alakaʻi koʻikoʻi no ke komo ʻana i ka manawa kūpono ma mua o ka emi ʻana o ka saturation oxygen.

Ka Nānā ʻana iā EtCO2

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

Ka Nānā ʻana i ka Pulse Oximetry

Ka nānā ʻana i ka pulse oximetry (SpO₂)hoʻohana i kahi mea ʻike manamana lima ʻaʻole invasive e ana i nā pae saturation oxygen koko, e hiki ai ke ʻike pono i ka hypoxemia. He maʻalahi kēia ʻano hana a kūpono hoʻi no ka nānā mau ʻana ma ka ʻaoʻao moe o nā poʻe maʻi ʻaʻole koʻikoʻi.

	Noi Lapaʻau	SpO₂	ʻO EtCO2
Mea hoʻoulu makani mīkini	Ka hoʻokomo ʻana o ka esophageal o ka paipu endotracheal	Lohi	Wikiwiki
	Ka hoʻokomo ʻana o ka bronchial i loko o ka ʻōmole endotracheal	Lohi	Wikiwiki
	Ka hopu ʻana o ka hanu a i ʻole ka pilina palupalu	Lohi	Wikiwiki
	Hoʻemi ʻia ka hanu ʻana	x	Wikiwiki
	Ka hanu nui ʻana	x	Wikiwiki
	Ua emi ka nui o ke kahe ʻana o ka oxygen	Wikiwiki	Lohi
Mīkini Anesthesia	Ka pau ʻana o ka soda lime/ka hanu hou ʻana	Lohi	Wikiwiki
Maʻi	ʻOkikene hoʻoulu haʻahaʻa	Wikiwiki	Lohi
	ʻO ka shunt intrapulmonary	Wikiwiki	Lohi
	ʻO ka embolism pulmonary	x	Wikiwiki
	ʻO ka hyperthermia ʻino	Wikiwiki	Wikiwiki
	Hoʻopaʻa ʻia ke kaʻapuni	Wikiwiki	Wikiwiki

Pehea e koho ai i nā mea komo a me nā mea hoʻopau CO₂?

ʻO ʻAmelika ʻĀkau ke aliʻi o ka mākeke i kēia manawa, e helu ana ma kahi o 40% o ka loaʻa kālā honua, ʻoiai ʻo ka ʻāina ʻo Asia-Pākīpika e manaʻo ʻia e hoʻopaʻa inoa i ka ulu wikiwiki loa, me kahi CAGR i wānana ʻia he 8.3% i ka manawa like. Ke alakaʻi nei i ka honuamea nānā maʻinā mea hana—e like meʻO Philips (Respironics), Medtronic (Oridion), ʻO Masimo, a me Mindray—ke hoʻomau nei i ka hana hou ʻana i ka ʻenehana EtCO2 e hoʻokō i nā pono e loli nei o ka anesthesia, ka mālama koʻikoʻi, a me ka lāʻau lapaʻau ulia pōpilikia.

No ka hoʻokō ʻana i nā koi lapaʻau a hoʻomaikaʻi i ka pono o ke kahe hana no nā limahana lapaʻau, ke kālele nei ʻo MedLinket i ka hoʻomohala ʻana a me ka hana ʻana i nā mea hoʻopau kiʻekiʻe, e like me nā laina laʻana, nā mea hoʻololi ea, a me nā pahele wai. Ua hoʻolaʻa ʻia ka ʻoihana i ka hāʻawi ʻana i nā hale mālama ola me nā hopena hoʻopau hilinaʻi no ka nānā ʻana i ka mainstream a me ka sidestream, i kūpono me nā lama nānā maʻi alakaʻi he nui, e kōkua ana i ka hoʻomohala ʻana o ke kahua nānā ʻana i ka hanu.

Nā mea ʻike etco2 nuia menā mea hoʻololi alaeaʻo ia nā mea pono a me nā mea hoʻopau maʻamau no ka nānā ʻana ma ke ʻano nui.

No ka nānā ʻana i ke kahawai ʻaoʻao,e noʻonoʻo e hoʻokomo pū me, nā mea ʻike ʻaoʻao, anā pahele wai，Laina laʻana CO2, ma muli o kāu mau pono hoʻonohonoho a me ka mālama ʻana.

Moʻo Pahele Wai
Mea Hana & Nā Hoʻohālike OEM	Kiʻi Kuhikuhi	# ʻOEM	Kōmike Kauoha	Nā wehewehe
Mindray Kūpono (Kina)
No nā monitor BeneView, iPM, iMEC, PM, MEC-2000 series, PM-9000/7000/6000 series, BeneHeart defibrillator		115-043022-00 (9200-10-10530)	RE-WT001A	Pahele wai laina maloʻo, Pākeke/Pediatirc no ka modula lua-ʻāpana, 10pcs/pahu
		115-043023-00 (9200-10-10574)	RE-WT001N	Pahele wai dryline, Neonatal no ka module dual-slot, 10pcs/pahu
No BeneVision, nā kiaʻi moʻo BeneView		115-043024-00 (100-000080-00)	RE-WT002A	Pahele wai Dryline II, Pākeke/Pediatirc no ka modula hoʻokahi-ʻāpana, 10pcs/pahu
		115-043025-00 (100-000081-00)	RE-WT002N	ʻO ka pahele wai Dryline II, Neonatal no ka module slot hoʻokahi, 10pcs/pahu
GE kūpono
Modula GE Solar Sidestream EtCO₂, GE MGA-1100 Mass Spectrometer ʻŌnaehana GE Advantage, Nā ʻŌnaehana Laʻana EtCO₂		402668-008	CA20-013	Hoʻohana hoʻokahi ka mea maʻi 0.8 micron Fitter, Luer Lock maʻamau, 20pcs/pahu
ʻO ka mīkini hanu makani GE Healthcare, monitor, anesthesia me ka module kinoea E-miniC		8002174	CA20-053	ʻO ka nui o ka ipu kūloko he > 5.5mL, 25pcs/pahu
Drager Hoʻohālikelike
ʻO Drager Babytherm 8004/8010 Babylog VN500 ventilator kūpono		6872130	WL-01	Hoʻohana hoʻokahi ʻia ʻo Waterlock no ka mea maʻi, 10pcs/pahu
Philips kūpono
Modula Kūlike：Philips – IntelliVue G5		M1657B / 989803110871	CA20-008	Pahele wai Philips, 15pcs/pahu
Philips kūpono			CA20-009	Pāpale wai Philips
Modula Kūlike：Philips – IntelliVue G7ᵐ		989803191081	WL-01	Hoʻohana hoʻokahi ʻia ʻo Waterlock no ka mea maʻi, 10pcs/pahu