TY  - JOUR
T1  - The effects of capnography during sedation in pediatric esophagogastroduodenoscopy procedures: A randomized controlled study
TT  - Pediatrik özafagogastroduodenoskopi işlemlerinde sedasyon sırasında kullanılan kapnografinin etkinliği: Randomize kontrollü çalışma
AU  - Tarıkçı Kılıç, Ebru
AU  - Gerenli, Nelgin
PY  - 2019
DA  - September
DO  - 10.17940/endoskopi.632022
JF  - Endoskopi Gastrointestinal
PB  - Türk Gastroenteroloji Vakfı
WT  - DergiPark
SN  - 1302-5422
SP  - 31
EP  - 37
VL  - 27
IS  - 2
LA  - en
AB  - Background and Aims: Microstreamcapnography monitors are devices that use nasal sample lines to measure pulse oximeterand end-tidal carbon dioxide values of spontaneously breathing patients.Research suggests that capnography is a more sensitive measure of ventilationthan standard modalities. This study aimed to determine whether addingcapnography to standard monitoring improves thedetection of respiratory depression in children undergoing esophagogastroduodenoscopywith sedation before hypoxemia occurs. Materials and Methods: We enrolled 100 children undergoing esophagogastroduodenoscopywith sedation in a pediatric endoscopy department. All children receivedstandard monitoring and capnography and were randomized to study (n = 50; capnography monitor) and control (n = 50; blind to monitor) groups. The primary outcome was an oxygendesaturation rate < 90%. Results: The control group hadhigher rates of hypoventilation and oxygen desaturationper minute and received more interventions than the study group. Untimelyinterventions with hypoventilation were associated with oxygendesaturation < 90%. All episodes of hypoventilation were due to hypopnea;however, medication, gender, and sedation duration were not significantlyassociated with this outcome. Conclusion: Hypoventilation is commonduring sedation of pediatric patients undergoingesophagogastroduodenoscopy. Capnography monitoring provides fewer but timelyinterventions for apnea and hypoventilation and improves the quality of careduring sedation. We, therefore, highly recommend the use of capnographymonitoring.
KW  - Esophagogastroduodenoscopy procedures
KW  - end-tidal carbon dioxide
KW  - capnography
KW  - hypopnea
KW  - hypoventilation
KW  - airway interventions
N2  - Girişve Amaç: Mikro-akım kapnografi, spontan soluyan hastalarda nazalhattı ile puls oksimetre, end-tidal karbon dioksit değerlerini izlemek içinkullanılan bir cihazdır. Bugüne kadar ki kanıtlar, kapnografi kullanılmasınınstandart yöntemlerden daha hassas bir ventilasyon ölçümü olduğunugöstermektedir. Çalışmamızda, özofagogastroduodenoskopi yapılan çocuklarınsedasyonu sırasında standart izlemeye kapnografi eklenmesinin hipoksemioluşmadan önce solunum depresyonunu tespit edip etmediğini belirlemeyiamaçladık. Gereç ve Yöntem: Pediatrikendoskopi bölümünde özofagogastroduodenoskopi uygulanan 100 çocuğa sedasyonuygulandı. İşleme alınan tüm çocuklara standart monitörizasyon ve kapnografiuygulandı ve randomizasyon ekibin kapnografi monitörünü (çalışma grubu) görüpgörmemesi veya monitöre (kontrol grubu) kör olup olmaması durumuna göreyapıldı. Birincil sonuç, oksijen desatürasyon oranı <% 90 idi. Bulgular: Randomize olarak her gruba 50kişi dahil edildi. Kontrol grubunda hipoventilasyon ve oksijen desatürasyonoranı daha yüksek bulundu. Havayolu müdahale oranları çalışma grubunda kontrolgrubuna göre daha az bulundu. Hipoventilasyon ile zamanında yapılmayanmüdahaleler oksijen desatürasyonu < 90 ile ilişkilendirildi.Tüm hipoventilasyon atakları hipopneyebağlıydı. İlaç kullanımı, cinsiyet, sedasyon süresi bu sonuçla anlamlı olarakilişkili bulunmadı. Sonuç: Özofagogastroduodenoskopiuygulanan pediatrik hastaların sedasyonu sırasında hipoventilasyon sıktır.Kapnografi kullanımı ise apne ve hipoventilasyon durumunda sayı olarak daha azancak tam zamanında hava yolu müdahalesi sağlayıp, sedasyon sırasındakikaliteyi artırır. Kapnografi kullanılmasını kesinlikle gerekli buluyoruz.
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UR  - https://doi.org/10.17940/endoskopi.632022
L1  - https://dergipark.org.tr/tr/download/article-file/831535
ER  -