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Master Thesis

Surveillance des intoxications médicamenteuses volontaires aux urgences par capnographie‎ : présentation d'une analyse intermédiaire‎ : étude Capnotox

Abstract : The severity of drug self-poisoning patients can be difficult to assess, and approximately 5% of patients who are admitted to the emergency department (ED) are secondarily transferred to intensive care unit (ICU). Non-invasive capnography (EtCO2) can identify respiratory complications during procedural sedation in the ED and could be useful in the monitoring of poisoned patients. Methods: This prospective and blind study was conducted in a single ED to evaluate the predictive values of EtCO2 measurements for the detection of complications in adult drug self-poisoning patients. Here we report the preliminary results of this study. Results: From 20/04/2012 to 20/02/2013, 104 patients were enrolled including 94 patients with measurable EtCO2. The correlation between EtCO2 and PaCO2 showed an estimated bias of -2,7 mmHg and limits of agreement between -11.8 mmHg and 6.5 mmHg. 15 patients exhibited at least one complication. EtCO2≥50mmHg predicted the occurrence of a complication with a sensitivity of 46.6% [95% CI: 22.3, 72.8] and a specificity of 75.9% [95% CI: 64.8, 84.6], which lead to a positive predictive value of 0.27 [95% CI: 0.19, 0.38] and a negative predictive value of 0.88 [95% CI: 0.78, 0.94]. The area under the Receiver Operating Characteristic curve (AUC) of the highest EtCO2 during the first 30 minutes of hospitalization was 0.74 [95% CI: 0.620, 0.864]. Glasgow Coma Scale at admission was as powerful as EtCO2 to detect complications (AUC: 0.76 [95% CI: 0.61, 0.91]). Conclusion: According to these preliminary results, the monitoring of EtCO2 alone cannot adequately predict early complications in self-poisoned patients referred to the ED.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00819769
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Submitted on : Thursday, May 2, 2013 - 12:01:53 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:03 AM
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  • HAL Id : dumas-00819769, version 1

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Delphine Bourez, Damien Viglino. Surveillance des intoxications médicamenteuses volontaires aux urgences par capnographie‎ : présentation d'une analyse intermédiaire‎ : étude Capnotox. Médecine humaine et pathologie. 2013. ⟨dumas-00819769⟩

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