Teo, Aik Howe
(2001)
Use of capnographic waveform indices in monitoring non - intubated asthmatic patients within the emergency department.
Masters thesis, Universiti Sains Malaysia.
Abstract
Untuk mengkaji sama ada kecuraman Fasa II dan Ill dan sudut
alpha (Q) gelombang kapnografi yang dikaji dapat menunjukkan perubahan dalam keadaan pesakit dengan serangan asma; dan untuk mengkaji sama ada perubahan
ini berkaitan dengan peru bah an dari segi klinikal dan pengukuran 'peak flow'.
Kami menjalankan kajian prospektif di Jabatan Kecemasan Hospital Universiti Sains Malaysia. 30 pesakit yang mengalami serangan asma akut dikaji
dari segi klinikal(kebolehan bertutur, kadar pernafasan, kadar nadi, pulsus
paradoxus, bunyi 'wheeze' dan 'pulse oximetry') dan pengukuran 'peak flow' diikuti dengan pengawasan 'sidestream' dengan kapnografi menggunakan 'nasal cannula'.
Gelombang kapnografi dicatitkan di dalam kad memori komputer (PC card). Pesakit dirawati dengan 'beta-agonists' dan 'steroids' mengikuti protokol jabatan. Selepas
rawatan, bila pesakit dianggap sihat untuk discaj, kajian semula dilakukan dengan kaedah klinikal, pengukuran 'peak flow' dan gelombang kapnografi. Kajian sebelum
rawatan dan selepas rawatan dikaji dengan ujian 'paired samples t-test'. Kajian 'correlations' dilakukan untuk mengetahui kaitan antara ketiga-tiga kaedah pengawasan ini. Nilai p < 0.05 dianggap ketara (significant).
To determine if the slope of Phase II and Phase Ill, and the alpha
angle (Angle Q) of the expiratory capnographic waveform measured via computerrecognizable
algorithms, can reflect changes in bronchospasm in acute asthmatic
patients presenting to the Emergency Department; and to assess the correlation of
these changes with clinical severity scoring and peak flow measurements.
We carried out a prospective study in a university hospital Emergency Department. 30 patients with acute asthma were monitored with clinical severity scoring (speech pattern, respiratory rate, pulse rate, presence of pulsus paradoxus
and wheeze, and pulse oximetry) and peak flow measurements, and then had a nasal cannula attached for sidestream sampling of expired carbon dioxide. The capnographic waveform was recorded onto a PC card for analysis. The patients were treated with inhaled beta-agonists and steroids according to departmental protocols. After treatment, when they were adjudged well for discharge, a second set of results was obtained for clinical severity scoring, peak flow measurements and capnographic waveform recording. The pre-treatment and post-treatment results
were then compared with paired samples t-test analysis. Sin1ple and canonical correlations were performed to determine correlations between the 3 assessment methods. A p value of below 0.05 was taken to be significant.
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