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Noninvasive monitoring of oxygen and carbon dioxide*

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Abstract

Pulse oximetry and capnography are widely used in clinical practice. They provide quick and noninvasive methods to estimate arterial oxygen saturation and carbon dioxide tension in different situations including emergency departments, intensive care units, and during procedures. This article reviews the principles of surgery, accuracy, limitations, and clinical applications of these instruments. (Am J Emerg Med 2001;19:141-146. Copyright © 2001 by W.B. Saunders Company)

Section snippets

Pulse oximetry

The introduction of pulse oximetry to clinical practice in the early 1980s offered a reliable, noninvasive, and easy to use tool of continuous monitoring of arterial oxygen saturation. In 1935 Kramer was the first to continuously measure the oxygen saturation of blood moving through an isolated artery of an animal using an instrument that transmits light through tissue.1 However, he was unable to differentiate arterial from capillary or venous oxygen saturation. In 1941 Milikan introduced an

Capnography

Capnometry is the measurement of CO2 concentration in a gas mixture. Continuous waveform display of the capnometer data throughout the ventilatory cycle is called capnography. The measurement of CO2 in respiratory gases was first accomplished in 1865 using the principles of infrared absorption. Capnography was developed in 1943 and introduced to clinical practice in the early 1950s.29 The most commonly used methods of capnography use infrared light absorption (infrared spectrometry) and mass

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    *

    Address reprint requests to Ayman O. Soubani, MD, Pulmonary and Critical Care Division, Harper University Hospital, 3 Hudson, 3990 John R, Detroit, MI 48201. E-mail: [email protected]

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