New Studies Support Better Post-Anesthesia Respiratory Monitoring

Medtronic plc is touting findings from two clinical studies that it says support use of its respiratory monitoring and capnography solutions.


With respiratory failure being the second-most frequently occurring preventable safety adverse event, causing higher mortality rates, longer hospital and intensive care unit stays, the billions of additional healthcare dollars spent each year make this a high profile issue.

The implication is that current monitoring strategies for early detection of postoperative respiratory compromise may be inadequate.

Medtronic supports the notion that comprehensive and continuous patient monitoring strategy encompassing respiratory rate, pulse oximetry and capnography, has the potential to reduce the incidence and severity of postoperative respiratory compromise, improve patient outcomes and reduce the cost of care.

Medtronic’s Integrated Pulmonary Index™ (IPI) is an algorithm that incorporates four real-time vital signs (end-tidal CO2, pulse oximetry, respiratory rate and pulse rate) into a single number. Its Microstream™  capnography plays a critical role in the post anesthesia care unit (PACU) to monitor for respiratory compromise, providing the earliest indication of a change to a patient`s breathing by measuring levels of exhaled carbon dioxide.

Presented at the ANESTHESIOLOGY® 2015 annual meeting in San Diego, the first cited paper was a validation of the clinical utility of the IPI in the PACU to identify so-called respiratory adverse events (RAE). The authors concluded that the sensitivity and specificity of IPI was better than that of SpO2 for RAE onset.

A second paper investigated the cost-effectiveness of capnography in gastrointestinal (GI) sedation (A reported 13 million patients use patient-controlled analgesia each year, with up to 678,000 of these patients experience life-threatening, opioid-induced respiratory depression). The study found that Microstream capnography was likely to be cost-effective and may have important applications to patient safety during endoscopy.

The study results highlight the need for clinicians to actively monitor for respiratory compromise following general anesthesia and procedural sedation with both pulse oximetry and capnography.

Investigator comments

“It is critical that patients who are administered any type of sedation, from general anesthesia to procedural sedation, be carefully monitored for signs of respiratory compromise,” said Hiroshi Morimatsu, MD, PhD, director, Anesthesiology and Resuscitology Department at Okayama University Hospital in Japan.

“Capnography monitoring can detect subtle changes in respiratory status and provide the earliest indication of airway compromise. The findings from this study provide further evidence of the necessity to use capnography, along with the Integrated Pulmonary Index, for postoperative patients, especially those with high risk of hypoventilation.”

“Capnography monitoring is considered the standard of care during deep sedation administered by anesthesiologists,” said John Vargo, MD, MPH, chair, Gastroenterology Department of the Digestive Disease Institute at the Cleveland Clinic.

“Our study results concluded that capnography can be cost effective when used during endoscopic sedation practices where a mixture of deep and moderate sedation is employed.”

Company comments

“The findings presented today demonstrate the clinical benefits and potential cost savings capnography can provide across a broad spectrum of patients,” said Michael Tarnoff, MD, vice president and chief medical officer, Minimally Invasive Therapies Group at Medtronic. “These studies underscore Medtronic`s commitment to reducing the growing burden of respiratory compromise across clinical settings to improve the health and care of patients.”

Source: Medtronic, plc

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