The Intensive Care Society has published guidelines on the use of capnography in critical care. The recommendations are:
- Capnography should be used for all critically ill patients during the procedures of tracheostomy or endotracheal intubation when performed in the intensive care unit.
- Capnography should be used in all critically ill patients who require mechanical ventilation during inter-hospital or intra- hospital transfer.
- Rare situations in which capnography is misleading can be reduced by increasing staff familiarity with the equipment, and by the use of bronchoscopy to confirm tube placement where the tube may be displaced but remains in the respiratory tract.
- Capnography offers the potential for non-invasive measurement of additional physiological variables including physiological dead space and total CO2 production.
- Capnography is not a substitute for estimation of arterial CO2.
- Careful consideration should be given to the type of capnography that should be used in an ICU. The decision will be influenced by methods used for humidification, and the advantages of active or passive humidification should be reviewed.
- Capnometry is an alternative to capnography where capnography is not available, for example where endotracheal intubation is required in general ward areas.