Rowan Courtney M, Speicher Richard H, Hedlund Terri, Ahmed Sheikh S, Swigonski Nancy L
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Pediatrics, University Hospitals of Cleveland, Cleveland, OH, USA.
J Clin Med Res. 2015 Feb;7(2):71-5. doi: 10.14740/jocmr1997w. Epub 2014 Nov 19.
Capnography provides a continuous, non-invasive monitoring of the CO2 to assess adequacy of ventilation and provide added safety features in mechanically ventilated patients by allowing for quick identification of unplanned extubation. These monitors may allow for decreased utilization of blood gases. The objective was to determine if implementation of continuous capnography monitoring decreases the utilization of blood gases resulting in decreased charges.
This is a retrospective review of a quality improvement project that compares the utilization of blood gases before and after the implementation of standard continuous capnography. The time period of April 2010 to September 2010 was compared to April 2011 to September 2011. Parameters collected included total number of blood gases analyzed, cost of blood gas analysis, ventilator and patient days.
The total number of blood gases after the institution of end tidal CO2 monitoring decreased from 12,937 in 2009 and 13,171 in 2010 to 8,070 in 2011. The average number of blood gases per encounter decreased from 20.8 in 2009 and 21.6 in 2010 to 13.8 post intervention. The blood gases per ventilator day decreased from 4.94 in 2009 and 4.76 in 2010 to 3.30 post intervention. The total charge savings over a 6-month period was $880,496.
Continuous capnography resulted in a significant savings over a 6-month period by decreasing the utilization of blood gas measurements.
二氧化碳监测可对二氧化碳进行连续、无创监测,以评估通气是否充分,并通过快速识别意外拔管情况,为机械通气患者提供额外的安全保障。这些监测仪可能会减少血气分析的使用。目的是确定实施连续二氧化碳监测是否会减少血气分析的使用,从而降低费用。
这是一项对质量改进项目的回顾性研究,比较了实施标准连续二氧化碳监测前后血气分析的使用情况。将2010年4月至2010年9月与2011年4月至2011年9月这两个时间段进行了比较。收集的参数包括分析的血气总数、血气分析成本、呼吸机使用天数和患者住院天数。
实施呼气末二氧化碳监测后,血气分析总数从2009年的12,937次和2010年的13,171次降至2011年的8,070次。每次诊疗的平均血气分析次数从2009年的20.8次和2010年的21.6次降至干预后的13.8次。每呼吸机日的血气分析次数从2009年的4.94次和2010年的4.76次降至干预后的3.30次。6个月期间节省的总费用为880,496美元。
连续二氧化碳监测在6个月期间通过减少血气测量的使用实现了显著的费用节省。