Abstract：
OBJECTIVE: This project aimed to implement a continuous capnography protocol in the postanesthesia care unit (PACU) for postoperative adult patients who are at high risk for respiratory failure.
METHODS: A preintervention and postintervention quality improvement design with retrospective chart reviews evaluated patient demographics (age, weight, body mass index [BMI], perioperative fluid intake and output, use of intraoperative positive-end expiratory pressure), length of surgery, average length of PACU stay, incidence of respiratory events, and adherence to a PACU capnography protocol.
METHODS: Preimplementation data were collected from retrospective chart reviews over a 3-month period. A continuous capnography protocol was implemented for same-day surgery patients with a BMI of 35 kg/m2 or greater and who received general anesthesia. Postimplementation data were collected over 3 months in addition to adherence to the capnography protocol. This was presented using descriptive statistics.
RESULTS: Age, length of surgery, weight, BMI, perioperative fluid intake and output, and use of positive-end expiratory pressure did not impact PACU length of stay. The average PACU length of stay decreased from 76.76 to 71.82 minutes postimplementation but was not statistically significant (P = .470). The incidence of respiratory events was 6% (n = 3). After the implementation of the continuous capnography protocol, adherence to the continuous capnography monitoring was 86% (n = 43).
CONCLUSIONS: Patients who are at high risk for postoperative respiratory failure may benefit from continuous capnography monitoring in the PACU. Capnography monitoring may decrease PACU length of stay and provide earlier detection of pending respiratory depression or failure than pulse oximetry alone.
METHODS: A preintervention and postintervention quality improvement design with retrospective chart reviews evaluated patient demographics (age, weight, body mass index [BMI], perioperative fluid intake and output, use of intraoperative positive-end expiratory pressure), length of surgery, average length of PACU stay, incidence of respiratory events, and adherence to a PACU capnography protocol.
METHODS: Preimplementation data were collected from retrospective chart reviews over a 3-month period. A continuous capnography protocol was implemented for same-day surgery patients with a BMI of 35 kg/m2 or greater and who received general anesthesia. Postimplementation data were collected over 3 months in addition to adherence to the capnography protocol. This was presented using descriptive statistics.
RESULTS: Age, length of surgery, weight, BMI, perioperative fluid intake and output, and use of positive-end expiratory pressure did not impact PACU length of stay. The average PACU length of stay decreased from 76.76 to 71.82 minutes postimplementation but was not statistically significant (P = .470). The incidence of respiratory events was 6% (n = 3). After the implementation of the continuous capnography protocol, adherence to the continuous capnography monitoring was 86% (n = 43).
CONCLUSIONS: Patients who are at high risk for postoperative respiratory failure may benefit from continuous capnography monitoring in the PACU. Capnography monitoring may decrease PACU length of stay and provide earlier detection of pending respiratory depression or failure than pulse oximetry alone.
摘要：
目的：该项目旨在在麻醉后监护病房（PACU）中对呼吸衰竭高风险的术后成年患者实施连续二氧化碳监测方案。
方法：采用回顾性图表评估的干预前和干预后质量改进设计评估了患者的人口统计（年龄，体重,体重指数[BMI]，围手术期液体摄入量和输出量，术中呼气末正压的使用)，手术长度,PACU平均停留时间,呼吸事件的发生率，并坚持PACU二氧化碳浓度监测方案。
方法：实施前数据收集自3个月的回顾性图表回顾。对BMI为35kg/m2或更高并接受全身麻醉的当日手术患者实施了连续二氧化碳图方案。除了遵守二氧化碳描记术方案外，还收集了3个月以上的灌注后数据。这是使用描述性统计数据呈现的。
结果：年龄，手术长度,体重,BMI,围手术期液体摄入量和输出量，呼气末正压的使用并不影响PACU的住院时间.PACU的平均住院时间从76.76分钟减少到71.82分钟，但没有统计学意义（P=0.470）。呼吸事件的发生率为6％（n=3）。实施连续二氧化碳监测方案后，连续二氧化碳监测的依从性为86%(n=43).
结论：术后呼吸衰竭高危患者可能受益于PACU的连续二氧化碳监测。二氧化碳监测可以减少PACU的住院时间，并比单独的脉搏血氧饱和度更早地检测即将发生的呼吸抑制或衰竭。
方法：采用回顾性图表评估的干预前和干预后质量改进设计评估了患者的人口统计（年龄，体重,体重指数[BMI]，围手术期液体摄入量和输出量，术中呼气末正压的使用)，手术长度,PACU平均停留时间,呼吸事件的发生率，并坚持PACU二氧化碳浓度监测方案。
方法：实施前数据收集自3个月的回顾性图表回顾。对BMI为35kg/m2或更高并接受全身麻醉的当日手术患者实施了连续二氧化碳图方案。除了遵守二氧化碳描记术方案外，还收集了3个月以上的灌注后数据。这是使用描述性统计数据呈现的。
结果：年龄，手术长度,体重,BMI,围手术期液体摄入量和输出量，呼气末正压的使用并不影响PACU的住院时间.PACU的平均住院时间从76.76分钟减少到71.82分钟，但没有统计学意义（P=0.470）。呼吸事件的发生率为6％（n=3）。实施连续二氧化碳监测方案后，连续二氧化碳监测的依从性为86%(n=43).
结论：术后呼吸衰竭高危患者可能受益于PACU的连续二氧化碳监测。二氧化碳监测可以减少PACU的住院时间，并比单独的脉搏血氧饱和度更早地检测即将发生的呼吸抑制或衰竭。
