A survey of Capnography utilization in Jakarta: initiation for standard of care

Capnography is a device that allows helath-care provider to continuously monitor the concentration or partial pressure of CO2 in respiratory gas.1 American Society of Anesthesiologist include end-tidal carbon dioxide monitoring as a mandatory monitoring for patient under moderate and deep sedation.2 However, Capnography is not widely consider for standard patient monitoring method in Indonesia. The aim of this study was to assess the utilization of capnography and the obstacles for adoption capnography as a standard of care. After obtaining approval from Research and Ethics Committee from our institution, internet base questionnaire was distributed to various health care providers in Jakarta who attended local annual meeting. Study data were collected and managed using REDCap electronic data capture tools hosted at Faculty of Medicine Universitas Indonesia. There were 145 respondents replies received, either were anesthesiologist (76.6%), another specialist (2%), general physician (5.5%), nurse (1%), other health care provider (13.8%). Our survey showed only 52.4% (n=76) responders reported availability of capnography in their hospital. However, 72.4% respondents considering capnography is important monitoring device irrespective of availability. Approximately 70% operating theater had capnography available. However, respondents who use capnography outside operating theater are low. Eighteen (25%) responders use capnography while doing a CPR, eight responders (11%) use capnography for sedation outside the OT, nine responders (12.5%) use capnography in the ER setting, and only four responders (5%) use capnography for monitor ETCO2 while transferring patient with artificial airway. The obstacle for not adopted capnography as standard patient monitoring was varied (figure 1). To conclude, utilization of capnography for intraoperative monitoring were widely adopted in Jakarta. However, utilization outside operating theater was still limited. Initiation for capnography as standard of care should be implemented.