Surgeons in Japan successfully evaluated the respiratory status of 163 patients in a study by using the Integrated Pulmonary Index (IPI). This algorithm, created by Medtronic, is derived of four real-time vital signs, including: end-tidal CO2, pulse oximetry, respiratory rate and pulse rate. The post-anesthesia care unit (PACU) patients included in the study were considered to be at high risk for hypoventilation, due to being more than 75 years old and being obese.
“Capnography monitoring can detect subtle changes in respiratory status and provide the earliest indication of airway compromise,” said Dr. Hiroshi Morimatsu, PhD, director, Anesthesiology and Resuscitology Department at Okayama University Hospital in Japan. “The findings from this study provide further evidence of the necessity to use capnography, along with the IPI, for postoperative patients, especially those with high risk of hypoventilation.”
To learn more about the study, presented at the Anesthesiology 2015 annual meeting, Surgical Products connected with Dr. Morimatsu.
How did the IPI algorithm impact your team?
Morimatsu: The IPI has played a critical role in helping clinicians and/or health care providers in the PACU to help identify respiratory adverse events (RAE), also referred to as respiratory compromise.
How can the U.S. use this index?
Morimatsu: Capnography has been used in the hospital setting for several years, most commonly in the operating suite. It is my understanding that capnography is used as a standard of care in the operating room but that each individual hospital establishes its own standards for the use of capnography in the PACU. It is for this reason that the results of this study are intriguing as it validates for the first time the utility of capnography to identify respiratory compromise among high-risk patients undergoing general surgery.
What do you think your U.S. peers should take away from this study?
Morimatsu: The use of capnography in Japan, in the U.S. and in other nations has been common place in the operating room. If there is one key take-away from this study is that it validates the importance of the use of the IPI in the PACU for high-risk patients to identify RAE. There is a need for clinicians to actively monitor for respiratory compromise following general anesthesia and incorporate a comprehensive and continuous patient monitoring strategy to potentially reduce this condition, and improve patient outcomes and reduce the cost of care. Respiratory compromise is the second-most frequently occurring preventable safety issue, and we can play an important role in reducing morality rates, hospital stays and save our healthcare system billions of healthcare dollars.