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End-Tidal Carbon Dioxide MeasurementCAPNO-PaCO2NCT07834411

Comparison of Capnography and Blood Gas PaCO₂ Measurements

An observational study of End-Tidal Carbon Dioxide Measurement and Capnography, run by Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Capnography provides continuous, non-invasive assessment of ventilation by measuring end-tidal carbon dioxide (EtCO₂). Different capnographic technologies, including mainstream, sidestream, and microstream capnography, may produce different EtCO₂ measurements depending on their sampling and measurement techniques. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Mainstream Capnography, Sidestream Capnography and Microstream Capnography
How many people
135 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 May 2024to 1 Jul 2024
How long will I take part?
1 Day
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The study population consisted of adult patients presenting to the Emergency Department of the University of Health Sciences Sultan II. Abdülhamid Han Training and Research Hospital between May 1, 2024, and July 1, 2024, for whom blood gas analysis was requested by the treating physician as part of routine clinical care. Eligible patients were required to be clinically suitable for end-tidal carbon dioxide (EtCO₂) measurement and to provide informed consent. A total of 135 participants who met the eligibility criteria were included in the study.

Inclusion Criteria:Age 18 years or older. Presentation to the emergency department with a clinical indication for blood gas analysis as determined by the treating physician.

Level of consciousness and clinical condition suitable for end-tidal carbon dioxide (EtCO₂) measurement.

Ability and willingness to provide informed consent for participation in the study.

Exclusion Criteria:Age younger than 18 years. Refusal or inability to provide informed consent. Pregnancy. Glasgow Coma Scale score below 15. Any anatomical deformity or condition preventing appropriate capnography measurement.

Sepsis. Diabetic ketoacidosis. Hypovolemic shock. Acute major bleeding. Severe dehydration.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • University of Health Sciences, Sultan II. Abdülhamid Han Training and Research Hospital

    Istanbul, Istanbul, 34668

Other trials in Turkey (Türkiye)

About this study

Official title: Correlation of End-Tidal Carbon Dioxide Values Measured by Different Capnographic Devices With Blood Gas Analysis in Patients Presenting to Emergency Department: A Prospective Non-Randomized Study

Capnography provides continuous, non-invasive assessment of ventilation by measuring end-tidal carbon dioxide (EtCO₂). Different capnographic technologies, including mainstream, sidestream, and microstream capnography, may produce different EtCO₂ measurements depending on their sampling and measurement techniques.

This prospective, non-randomized observational study was designed to compare EtCO₂ values obtained using mainstream, sidestream, and microstream capnography with carbon dioxide partial pressure (PCO₂) values obtained from clinically indicated blood gas analysis in adult patients presenting to the emergency department.

For each participant, EtCO₂ measurements were obtained using the three capnographic methods in close temporal proximity to blood gas sampling. The relationship and agreement between blood gas PCO₂ and EtCO₂ measurements were planned to be evaluated using correlation analyses and Bland-Altman analysis. Additional analyses were planned according to whether the blood gas sample was arterial or venous.

Read the detailed description

This prospective, non-randomized, cross-sectional observational study was conducted in the Emergency Department of the University of Health Sciences Sultan II. Abdülhamid Han Training and Research Hospital.

The study population consisted of adult patients presenting to the emergency department for whom blood gas analysis was requested by the treating physician as part of routine clinical care.

The primary objective of the study was to evaluate the agreement between blood gas PCO₂ measurements and end-tidal carbon dioxide (EtCO₂) values obtained using three different capnographic technologies: mainstream, sidestream, and microstream capnography.

A secondary objective was to compare the agreement of each capnographic method with blood gas PCO₂ measurements and to evaluate whether the relationship differed according to the type of blood gas sample, arterial or venous.

Eligible participants were adults aged 18 years or older whose level of consciousness and clinical condition were suitable for EtCO₂ measurement and who provided informed consent. Exclusion criteria included age younger than 18 years, pregnancy, refusal or inability to provide informed consent, Glasgow Coma Scale score below 15, and clinical or anatomical conditions preventing appropriate capnographic measurement. Patients with sepsis, diabetic ketoacidosis, hypovolemic shock, acute major bleeding, or severe dehydration were also excluded because these conditions could potentially affect the relationship between EtCO₂ and blood gas PCO₂.

For each participant, EtCO₂ measurements were obtained using mainstream, sidestream, and microstream capnography. Blood gas sampling was performed simultaneously with or in close temporal proximity to the capnographic measurements.

For mainstream capnography, participants breathed through an airway interface connected directly to the capnography sensor, and EtCO₂ measurements were recorded after a stable capnogram had been obtained over consecutive respiratory cycles. Sidestream and microstream EtCO₂ measurements were obtained using the corresponding sampling interfaces connected to the respective capnography monitors.

Demographic and clinical variables, including age, sex, height, weight, smoking status, relevant chronic diseases, and blood gas parameters, were recorded.

The association between blood gas PCO₂ and EtCO₂ values obtained using each capnographic method was planned to be evaluated using correlation analysis. Agreement between blood gas PCO₂ and EtCO₂ measurements was planned to be assessed using Bland-Altman analysis. Prespecified subgroup analyses were planned according to whether the blood gas sample was arterial or venous.

Being tested
Mainstream Capnography, Sidestream Capnography, Microstream Capnography
Keywords
Keywords: end-tidal carbon dioxide, blood gas analysis, mainstream capnography, sidestream capnography, microstream capnography

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mainstream CapnographyDiagnostic test

    End-tidal carbon dioxide (etCO2) was measured using mainstream capnography. Participants were asked to breathe through an endotracheal tube connected to the capnography sensor, and monitoring was continued for at least six breaths to obtain a stable measurement. The mainstream etCO2 value was recorded simultaneously or in close temporal proximity to clinically indicated blood gas sampling and was compared with the PCO2 value obtained from the blood gas analysis.

  • Sidestream CapnographyDiagnostic test

    End-tidal carbon dioxide (etCO2) was measured using sidestream capnography. A nasal cannula connected to the capnography monitor was placed in the participant's nostrils, and exhaled carbon dioxide was sampled during spontaneous breathing. The sidestream etCO2 value was recorded simultaneously or in close temporal proximity to clinically indicated blood gas sampling and was compared with the PCO2 value obtained from the blood gas analysis.

  • Microstream CapnographyDiagnostic test

    End-tidal carbon dioxide (etCO2) was measured using microstream capnography. A nasal cannula connected to the capnography monitor was placed in the participant's nostrils, and exhaled carbon dioxide was sampled during spontaneous breathing. The microstream etCO2 value was recorded simultaneously or in close temporal proximity to clinically indicated blood gas sampling and was compared with the PCO2 value obtained from the blood gas analysis.

Study groups in NCT07834411
Study groupRoleWhat they receive
Arterial Blood Gas CohortAdult patients presenting to the emergency department who underwent clinically indicated arterial blood gas analysis. In each participant, end-tidal carbon dioxide (etCO₂) was measured using mainstream, sidestream, and microstream capnography simultaneously or in close temporal proximity to blood gas sampling. Capnographic etCO₂ measurements were compared with arterial PaCO₂ values. No randomization was performed, and all three capnographic methods were applied to each participant.
Receives: Diagnostic Test: Mainstream Capnography; Diagnostic Test: Sidestream Capnography; Diagnostic Test: Microstream Capnography
Venous Blood Gas CohortAdult patients presenting to the emergency department who underwent clinically indicated venous blood gas analysis. In each participant, end-tidal carbon dioxide (etCO₂) was measured using mainstream, sidestream, and microstream capnography simultaneously or in close temporal proximity to blood gas sampling. Capnographic etCO₂ measurements were compared with venous blood gas PCO₂ values. No randomization was performed, and all three capnographic methods were applied to each participant.
Receives: Diagnostic Test: Mainstream Capnography; Diagnostic Test: Sidestream Capnography; Diagnostic Test: Microstream Capnography

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Agreement Between PaCO₂ and EtCO₂ Measurements Obtained Using Mainstream, Sidestream, and Microstream Capnography

    Agreement between blood gas PaCO₂ and end-tidal carbon dioxide (EtCO₂) measurements obtained using mainstream, sidestream, and microstream capnography. Agreement was assessed using Bland-Altman analysis by calculating the mean difference (bias) and 95% limits of agreement for each capnography method compared with blood gas PaCO₂.

    Measured: Within 1 day of emergency department assessment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Sep 2026
  2. Study start1 May 2024
  3. Primary completion1 Jul 2024
  4. Study completion1 Jul 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
135 participants (actual)
Target duration
1 Day
IDs, dates and publications
ClinicalTrials.gov ID
NCT07834411
Sponsor's protocol ID
HNEAH-KAEK 2024/34-4323
Acronym
CAPNO-PaCO2
Status last verified
Sep 2026
First submitted
3 Sep 2026
Last updated
22 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is no formal plan for public sharing of individual participant data. De-identified data may be made available by the corresponding author upon reasonable request, subject to applicable ethical and institutional requirements.

Publications

  • Delerme S, Freund Y, Renault R, Devilliers C, Castro S, Chopin S, Juillien G, Riou B, Ray P. Concordance between capnography and capnia in adults admitted for acute dyspnea in an ED. Am J Emerg Med. 2010 Jul;28(6):711-4. doi: 10.1016/j.ajem.2009.04.028. Epub 2010 Mar 25.

    PubMed 20637388
  • Casati A, Gallioli G, Passaretta R, Scandroglio M, Bignami E, Torri G. End tidal carbon dioxide monitoring in spontaneously breathing, nonintubated patients. A clinical comparison between conventional sidestream and microstream capnometers. Minerva Anestesiol. 2001 Apr;67(4):161-4.

    PubMed 11376503
  • Nijbroek SGLH, Roozeman JP, Ettayeby S, Rosenberg NM, van Meenen DMP, Cherpanath TGV, Lagrand WK, Tepaske R, Klautz RJM, Serpa Neto A, Schultz MJ. Closed-Loop ventilation using sidestream versus mainstream capnography for automated adjustments of minute ventilation-A randomized clinical trial in cardiac surgery patients. PLoS One. 2023 Aug 23;18(8):e0289412. doi: 10.1371/journal.pone.0289412. eCollection 2023.

    PubMed 37611007
  • Duyu M, Bektas AD, Karakaya Z, Bahar M, Gunalp A, Caglar YM, Yersel MN, Bozkurt O. Comparing the novel microstream and the traditional mainstream method of end-tidal CO2 monitoring with respect to PaCO2 as gold standard in intubated critically ill children. Sci Rep. 2020 Dec 16;10(1):22042. doi: 10.1038/s41598-020-79054-y.

    PubMed 33328527

Questions about this trial

What is this clinical trial studying?

An observational study of End-Tidal Carbon Dioxide Measurement and Capnography, run by Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Agreement Between PaCO₂ and EtCO₂ Measurements Obtained Using Mainstream, Sidestream, and Microstream Capnography (time frame: Within 1 day of emergency department assessment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07834411, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2026.

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