ABSTRACT
An end-tidal CO2 (ETCO2) monitor (capnometer) is used most often as a noninvasive substitute for PaCO2 in anesthesia, anesthetic recovery and intensive care. However, the utility and accuracy of the portable capnometer in spontaneously breathing patients with or without chronic pulmonary diseases has received little recognition. To determine the utility of the portable capnometer in general wards and in in-home care, we examined the correlation between ETCO2 measured by a portable capnometer and simultaneous PaCO2 measured in 41 spontaneously breathing patients. TV-ETCO2 (ETCO2 measured by tidal volume maneuver) was lower than PaCO2 by an average of 9.0 mmHg and VC-ETCO2 (ETCO2 measured by vital capacity maneuver) was lower than PaCO2 by an average of 0.5 mmHg. The mean difference between PaCO2 and VC-ETCO2 was not statistically significant. Regression analysis showed a close correlation between VC-ETCO2 and PaCO2 (r = 0.91, P < 0.0001). Thus,VC-ETCO2 was highly correlated with PaCO2. Furthermore, a close correlation between VC-ETCO2 and PaCO2 was also observed in patients with compromised pulmonary function (r = 0.88, P < 0.0001 in patients with below 70% of FEV(1.0)%; r = 0.89, P < 0.0001 in patients with below 80% of %VC). Our studies show that VC-ETCO2 measured by the portable capnometer gives a reliable pointestimate of PaCO2, and can be useful to evaluate the respiratory condition of spontaneously breathing patients in general wards and in in-home care.
Subject(s)
Capnography/methods , Carbon Dioxide/analysis , Lung Diseases/metabolism , Aged , Breath Tests/methods , Carbon Dioxide/blood , Female , Forced Expiratory Volume , Humans , Lung Diseases/blood , Lung Diseases/physiopathology , Male , Middle Aged , Partial Pressure , Point-of-Care Systems , Reproducibility of Results , Tidal Volume , Vital CapacityABSTRACT
Several reports have suggested that the prevalence of asthma in adults is currently increasing. However, recent prevalence of asthma has not reported in Japan, especially in rural-mountain areas. To investigate the prevalence of asthma in adults in Japan, we conducted clinical epidemiological research on 5066 inhabitants of Menda town, in a rural-mountain area of Japan. The study population comprised 98.7% of adults in the town, including senior high school students whose age were more than 15 years old. The prevalence of asthma among adults was 3.6%. The ratio of prevalence in males to prevalence in females was 1.44. Peaks prevalences were observed in the age ranges of 15-19 and > 70 years old in males, and 15-19, 40-49 and > 70 years old in females.
Subject(s)
Asthma/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Female , Humans , Japan/epidemiology , Male , Middle Aged , Prevalence , Rural Health/statistics & numerical dataABSTRACT
A 53-year-old man with acute promyelocytic leukemia (APL) treated with all-trans retinoic acid (ATRA) developed fever and small erythemas on his arms and legs when the peripheral blood neutrophil count had increased. Erythemas gradually enlarged and painful subcutaneous nodules appeared. Skin biopsy revealed dense neutrophil infiltration in the dermis without vasculitis. These findings were compatible with Sweet's syndrome. Treatment with ATRA for APL was continued and no other additional therapy for Sweet's syndrome was performed. The syndrome was spontaneously improved in parallel with improvement of APL. In addition to this case report, three previously reported cases were reviewed to clarify the clinical characteristics of Sweet's syndrome in patients with APL during treatment with ATRA.
