A review of pediatric capnography.

OBJECTIVES

Capnography has become a standard of perioperative monitoring in pediatric anesthesiology. It has also begun to find application in a variety of situations outside the perioperative setting. While the use of capnography has been increasing, the dissemination and acceptability of capnography in all areas of pediatrics has been variable. The purpose of this study was to describe all the applications and interpretations of capnography that have been reported in children.

METHODS

In March 2010, we completed a search of peer reviewed literature from MEDLINE (from 1950), CINAHL (from 1982) and the Cochrane Library. Final search results were limited to publications in which the primary intent was to describe the application or interpretations of capnography in children.

RESULTS

This search resulted in a list of 44 applications and interpretations of capnography. We classified the applications and interpretations of capnography in children into six categories--Anesthetic Delivery Apparatus, Airway, Breathing, Circulation, Homeostasis and Non-perioperative. We discuss the four randomized controlled trials describing the use of capnography in children. Based on the available evidence, we have also assigned grades of recommendations for these applications and interpretations.

CONCLUSIONS

Capnography has been proven to be a useful non-invasive perioperative monitor of the physiology and safety of the child. This list of the clinical applications and interpretations of capnography could find use in teaching and simulation in pediatrics.