Capnography monitoring during procedural sedation and analgesia: A systematic review protocol

Conway, Aaron, Douglas, Clint, & Sutherland, Joanna (2015) Capnography monitoring during procedural sedation and analgesia: A systematic review protocol. Systematic Reviews, 4(92).

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An important potential clinical benefit of using capnography monitoring during procedural sedation and analgesia (PSA) is that this technology could improve patient safety by reducing serious sedation-related adverse events, such as death or permanent neurological disability, which are caused by inadequate oxygenation. The hypothesis is that earlier identification of respiratory depression using capnography leads to a change in clinical management that prevents hypoxaemia. As inadequate oxygenation/ventilation is the most common reason for injury associated with PSA, reducing episodes of hypoxaemia would indicate that using capnography would be safer than relying on standard monitoring alone.


The primary objective of this review is to determine whether using capnography during PSA in the hospital setting improves patient safety by reducing the risk of hypoxaemia (defined as an arterial partial pressure of oxygen below 60 mmHg or percentage of haemoglobin that is saturated with oxygen [SpO2] less than 90 %). A secondary objective of this review is to determine whether changes in the clinical management of sedated patients are the mediating factor for any observed impact of capnography monitoring on the rate of hypoxaemia. The potential adverse effect of capnography monitoring that will be examined in this review is the rate of inadequate sedation. Electronic databases will be searched for parallel, crossover and cluster randomised controlled trials comparing the use of capnography with standard monitoring alone during PSA that is administered in the hospital setting. Studies that included patients who received general or regional anaesthesia will be excluded from the review. Non-randomised studies will be excluded. Screening, study selection and data extraction will be performed by two reviewers. The Cochrane risk of bias tool will be used to assign a judgment about the degree of risk. Meta-analyses will be performed if suitable.


This review will synthesise the evidence on an important potential clinical benefit of capnography monitoring during PSA within hospital settings.

Systematic review registration: PROSPERO CRD42015023740

Impact and interest:

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ID Code: 85432
Item Type: Journal Article
Refereed: Yes
Keywords: Deep sedation, Conscious sedation, sedation, capnography, end-tidal carbon dioxide, nursing, hospital, opioid
DOI: 10.1186/s13643-015-0085-4
ISSN: 2046-4053
Subjects: Australian and New Zealand Standard Research Classification > TECHNOLOGY (100000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2015 Conway et al.
Copyright Statement: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Deposited On: 14 Jul 2015 22:46
Last Modified: 25 Jun 2017 03:02

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