RESUMO
BACKGROUND: Pulse oximetry is a widely accepted procedure for ventilatory monitoring during gastrointestinal endoscopy, but this method provides an indirect measurement of the respiratory function. In addition, detection of abnormal ventilatory activity can be delayed, especially if supplemental oxygen is provided. Capnography offers continuous real-time measurement of expiratory carbon dioxide. OBJECTIVE: We aimed at prospectively examining the advantages of capnography over the standard pulse oximetry monitoring during sedated colonoscopies. PATIENTS AND METHODS: Fifty patients undergoing colonoscopy were simultaneously monitored with pulse oximetry and capnography by using two different devices in each patient. Several sedation regimens were administered. Episodes of apnea or hypoventilation detected by capnography were compared with the occurrence of hypoxemia. RESULTS: Twenty-nine episodes of disordered respiration occurred in 16 patients (mean duration 54.4 seconds). Only 38% of apnea or hypoventilation episodes were detected by pulse oximetry. A mean delay of 38.6 seconds was observed in the events detected by pulse oximetry (two episodes of disturbed ventilation were simultaneously detected by capnography and pulse oximetry). CONCLUSIONS: Apnea or hypoventilation commonly occurs during colonoscopy with sedation. Capnography is more reliable than pulse oximetry in early detection of respiratory depression in this setting.
Assuntos
Capnografia , Dióxido de Carbono/sangue , Colonoscopia , Sedação Consciente/efeitos adversos , Sedação Profunda/efeitos adversos , Hipnóticos e Sedativos/efeitos adversos , Oximetria , Oxigênio/sangue , Propofol/efeitos adversos , Insuficiência Respiratória/diagnóstico , Adulto , Idoso , Apneia/sangue , Apneia/diagnóstico , Apneia/etiologia , Sistemas Computacionais , Feminino , Humanos , Hipoventilação/sangue , Hipoventilação/diagnóstico , Hipoventilação/etiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Insuficiência Respiratória/sangue , Insuficiência Respiratória/induzido quimicamenteRESUMO
Background: pulse oximetry is a widely accepted procedurefor ventilatory monitoring during gastrointestinal endoscopy, butthis method provides an indirect measurement of the respiratoryfunction. In addition, detection of abnormal ventilatory activitycan be delayed, especially if supplemental oxygen is provided.Capnography offers continuous real-time measurement of expiratorycarbon dioxide.Objective: we aimed at prospectively examining the advantagesof capnography over the standard pulse oximetry monitoringduring sedated colonoscopies.Patients and methods: fifty patients undergoing colonoscopywere simultaneously monitored with pulse oximetry and capnographyby using two different devices in each patient. Several sedationregimens were administered. Episodes of apnea or hypoventilationdetected by capnography were compared with the occurrence ofhypoxemia.Results: twenty-nine episodes of disordered respiration occurredin 16 patients (mean duration 54.4 seconds). Only 38% ofapnea or hypoventilation episodes were detected by pulse oximetry.A mean delay of 38.6 seconds was observed in the events detectedby pulse oximetry (two episodes of disturbed ventilationwere simultaneously detected by capnography and pulse oximetry).Conclusions: apnea or hypoventilation commonly occursduring colonoscopy with sedation. Capnography is more reliablethan pulse oximetry in early detection of respiratory depression inthis setting(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Capnografia/métodos , Capnografia/tendências , Insuficiência Respiratória/complicações , Insuficiência Respiratória/diagnóstico , Colonoscopia/tendências , Colonoscopia , Endoscopia do Sistema Digestório/métodos , Endoscopia Gastrointestinal , Estudos Prospectivos , Hipoventilação/complicações , Hipoventilação/diagnóstico , Apneia do Sono Tipo Central/complicaçõesRESUMO
Results of a study carried out in 21 patients with acetylsalicylic acid (Aspirin), hypersensitivity, 17 females and 4 males, aged 16 to 69 years (mean 45.7) are presented. Some patients suffered from several types of allergic symptoms - 11 from Asthma, 3 Rhinitis, 3 Quinke edema, 5 Urticaria and 2 Anaphylactic Shock. Concomitant drug allergies, route of administration and composition of the ingested drug, familiar complaints of drug allergy, nasopharyngeal examination and lung function by spirometry and Acetylcholine tests were evaluated. Blood, sputum and nasal mucous eosinophil count, as well as secretory IgA and its secretory piece identification in saliva and nasal mucous, serotonin and histaminopexic power of serum and immunoelectrophoresis of serum proteins were performed in all patients. Human basophil degranulation test to Aspirin were evaluated in 12 patients. Skin prick tests with one standard range of 21 common allergens were done in all patients and intradermal skin tests with 1 lysine acetyl-salicylate (1/100 and 1/1000) were performed in all patients as well as in a selected control group of 12 healthy subjects.
