Capnography, the technique that measures CO2 in expiratory gases, has become an intrinsic part of anesthesia monitoring, close observation of patients in intensive care units, and detection of respiratory diseases.
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Capnography was first developed by Luft in 1943, based on the knowledge that CO2 is one of the gases that can absorb infrared (IR) radiation. With consistent progress, a research team led by Collier became the first to accurately analyze IR absorbed in CO2 to determine alveolar CO2 concentration and the end tidal value was established by a researcher named Ramwell.
In 1978, capnography was first adopted in the Netherlands to be used as a standard for anesthesia monitoring. In the late 1980s, innovations in mainstream gas sensors led to the development of smaller, robust mainstream carbon dioxide (CO2) sensors, which included pulsating thick film infrared sources amplified by the robustness of a coaxial optical design.
With further technological evolution, by the early 1990s, volumetric capnography sensors that performed dual function were developed. The device combines mainstream flow and CO2 as well as sidestream sensors and CO2 into an integrated airway adapter. For both sidestream sensors and mainstream sensors, technological advancement continues, the former being equipped with newer source designs and novel configurations, and the latter with digital signal processors and miniaturization of optics.
How is technology helping capnography gain traction?
With significant technical limitations in blackbody infrared technology used in conventional sidestream and mainstream capnography, the tool was restricted for monitoring for operating room environments.
However, with the advent of microstream technology for CO2 monitoring, which is based on molecular correlation spectroscopy, has resulted in a highly efficient and selective emission of a range of discrete infrared wavelengths to measure CO2 absorption.
The emissions, which are specific for CO2, allow an extremely small sample cell (15 microl) for the sample to use a very low rate (50 ml/min) not affecting the end-tidal CO2 accuracy or waveform integrity
Capnography Equipment Market – A Snapshot
Based on a recent market study by Transparency Market Research (TMR), the observations pertaining to the utilization of capnography are charted below:
> In North America and Europe, standards and reforms in place by independent regulatory bodies for the use of capnography equipment and high incidence of respiratory diseases is favorable to the growth of the global capnography market.
> As per World Health Organization (WHO) statistics, in 2013, approximately 235 million people were asthma-afflicted. Such high incidence of respiratory diseases is increasing demand for innovative diagnostic techniques, thus leading to the demand for capnography equipment.
> Sidestream capnographs find maximum use due to their ease of use, availability of handheld and portable devices, and capability of the device for patient monitoring in non-intubated conditions.
> The hospitals segment leads the capnography equipment market due to growing respiratory conditions and morbidity and mortality associated with these conditions.
> Strong recommendations by the Association of Anesthetists of the Great Britain & Ireland (AAGBI), the Intensive Care Society U.K., and European Resuscitation Council (ERC) for the use of capnography equipment hold promise for the global capnography market. Moreover, for safe administration of sedation procedures, as per the Dutch Sedation Guidelines, the use of capnography is mandatory when performed by non-anesthesiologists.
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