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. 2021 Sep 1;17(6):e557-e561.
doi: 10.1097/PTS.0000000000000408.

Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue by Hospital Rapid Resuscitation Team

Mindy Stites  1 , Jennifer Surprise  1 , Jennifer McNiel  2 , David Northrop  3 , Martin De Ruyter  4
Affiliations

Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue by Hospital Rapid Resuscitation Team

Mindy Stites et al. J Patient Saf. .

Abstract

Objective: The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response.

Methods: A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015. In March 2013, continuous capnography monitoring was implemented for all patients using PCA.

Results: The preintervention incidence of OIRD in the setting of rapid response was 0.4% of patients receiving opioids. After the implementation of capnography, the incidence of OIRD in the setting of rapid response was reduced to 0.2%, which was statistically significant (χ2 = 46.246; df, 1; P < 0.0001). The rate of transfers to a higher level of care associated with these events was also reduced by 79% (baseline, 7.6 transfers/month; postintervention, 1.6 transfers/month).

Conclusions: Continuous capnography monitoring in patients receiving PCA significantly reduces the incidence of OIRD in the setting of rapid response and unplanned transfers to a higher level of care.

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Conflict of interest statement

The authors disclose no conflict of interest.

References

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    1. Institute for Safe Medication Practices (ISMP). Fatal PCA Adverse Events Continue to Happen ... Better Patient Monitoring Is Essential to Prevent Harm. May 30, 2013. Available at: https://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=50 . Accessed May 22, 2017.
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