Capnography enhances surveillance of respiratory events during procedural sedation: a meta-analysis

J Clin Anesth. 2011 May;23(3):189-96. doi: 10.1016/j.jclinane.2010.08.012. Epub 2011 Apr 14.


Study objective: To determine if capnography, in addition to standard monitoring, identified more respiratory complications than standard monitoring alone.

Design: Meta-analysis.

Setting: University medical center.

Measurements: The electronic databases PubMed, CINAHL, and Cochrane Library (Cochrane Reviews, CENTRAL) were searched for studies published between 1995-2009 reporting adverse respiratory events during procedural sedation and analgesia (PSA) with clearly defined end-tidal carbon dioxide threshold, adult population, clear study design, P-value calculation, similar outcome and predictor variable definitions, and binary independent and dependent variable raw data. Five such studies were evaluated independently. A meta-analysis of these studies was performed.

Main results: During PSA, cases of respiratory depression were 17.6 times more likely to be detected if monitored by capnography than cases not monitored by capnography (95% CI, 2.5-122.1; P < 0.004).

Conclusion: End-tidal carbon dioxide monitoring is an important addition in detecting respiratory depression during PSA.

Publication types

  • Meta-Analysis

MeSH terms

  • Apnea / etiology
  • Capnography / methods*
  • Carbon Dioxide / metabolism
  • Conscious Sedation / adverse effects*
  • Humans
  • Prospective Studies
  • Respiratory Insufficiency / diagnosis*
  • Respiratory Insufficiency / etiology


  • Carbon Dioxide