PO-0839Capnography In Patients With Severe Neurological Impairment

BackgroundRespiratory disease is a common reason for hospitalisation and mortality in persons with severe intellectual and developmental disability. Assessment of acute respiratory decompensation and differentiating it from chronic pathology is a frequently encountered challenge. Partial pressure of CO2 is commonly used as an aid in this setting.AimTo evaluate baseline end tidal CO2 (EtCO2) levels using non-invasive side stream capnometry and to identify factors correlated with higher capnometry readings in this patient population.MethodsThis was a prospective, case controlled, cross sectional study to assess differences of baseline EtCO2 values between neurologically impaired patients and healthy individuals. Patient's demographic and clinical data were recorded. Variables correlating with higher EtCO2 readings and those that may predict clinically meaningful difference among neurologically impaired patients were evaluated.ResultsSeventy eight patients and 53 healthy individuals were included. The mean ( plus or minus SD) EtCO2 values were higher for neurologically impaired patients as compared to healthy individuals (39.14 plus or minus 3.59 and 37.11 plus or minus 1.88 mmHg respectively; p < 0.0001), and highest among patients using antipsychotic medications (41.53 plus or minus 5.257 mmHg). Kyphoscoliosis and the use of antipsychotic drugs were the major factors to increase EtCO2 levels.ConclusionKnowing the patient's baseline EtCO2 value, as well as baseline oximetry, could guide treatment decisions, when assessing the patient's oxygenation and ventilation during acute respiratory illness. Future research can shed light on the utility of capnometry and clinical implications of higher baseline EtCO2 values among neurologically impaired patients.