Capnography is a graphic representation of the carbon dioxide concentration in the airways plotted against time. We report an unusual biphasic-shaped capnogram in a single-lung transplant recipient. In keeping with the only 2 prior reports of which we are aware, we ascribe the unusual biphasic pattern to differential emptying of the native and transplanted lungs. This experience reminds respiratory clinicians of the value of capnometry as a monitoring tool and hopefully will heighten awareness regarding the diagnostic value of usual and unusual capnographic patterns.
WalshBK, CrotwellDN, RestrepoRD. Capnography/capnometry during mechanical ventilation: 2011. Respir Care, 2011; 56(4):503-509.
2.
CheifetzIM, MyersTR. Should every mechanically ventilated patient be monitored with capnography from intubation to extubation?. Respir Care, 2007; 52(4):423-438; discussion 438-442.
3.
AndersonCT, BreenPH. Carbon dioxide kinetics and capnography during critical care. Crit Care, 2000; 4(4):207-215.
4.
OrtegaR, ConnorC, KimS, DjangR, PatelK. Monitoring ventilation with capnography. N Engl J Med, 2012; 367(19):e27.
5.
WilliamsEL, JellishWS, ModicaPA, EngCC, TempelhoffR. Capnography in a patient after single lung transplantation. Anesthesiology, 1991; 74(3):621-622.
6.
SrinivasaV, KodaliBS, HartiganPM. Evolving capnograms after single lung transplant. Anesth Analg, 2004; 98(5):1504.
7.
NicholsKP, BenumofJL. Biphasic carbon dioxide excretion waveform from a patient with severe kyphoscoliosis. Anesthesiology, 1989; 71(6):986-987.
8.
GilbertD, BenumofJL. Biphasic carbon dioxide elimination waveform with right mainstem bronchial intubation. Anesth Analg, 1989; 69(6):829-832.
