What is the role of end-tidal carbon dioxide (ETCO2) testing in the workup of venous air embolism (VAE)?

Updated: Dec 30, 2017
  • Author: Brenda L Natal, MD, MPH; Chief Editor: Erik D Schraga, MD  more...
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Answer

VAE leads to ventilation/perfusion (V/Q) mismatching and increases in physiologic dead space. This produces a fall in end-tidal CO2 (normal value, <5). A 2 mm Hg change in end-tidal carbon dioxide (ETCO2) can be an indicator of VAE. However, this finding is nonspecific and may also occur with other disease states, such as pulmonary embolism (PE), massive blood loss, hypotension, circulatory arrest, upper-airway obstruction, mouth breathing, and/or disconnection from monitor. The detector also has a slow response time. [1, 4, 15, 22, 23]


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