DIAGNOSTIC POTENTIAL OF THE CAPNOGRAPHY METHOD FOR ASSESSING THE SEVERITY OF METABOLIC DIS- ORDERS IN PATIENTS IN THE INTENSIVE CARE UNIT

The review is devoted to the pathogenetic features of the formation of metabolic disorders in critical state medicine and to integral methods for monitoring their severity - capnography and the calculated indicators obtained using this method. A component of the pathogenesis of the septic process is metabolic stress, characterized by a violation of all types of metabolism, forming a cycle of interdependent processes that potentiate tissue oxygenation and microcirculation disorders. It was revealed that in the scientific literature this condition has been defined as microcirculatory-mitochondrial distress syndrome. Almost all metabolic processes are accompanied by the completion of glucose catabolism by the formation of carbon dioxide and water, carbon dioxide, in turn, having high diffusion activity, quickly gets from the tissues through the microvasculature into the systemic circulation and is eliminated with exhaled air. In this regard, it is possible to dynamically assess the level of metabolism in tissues by the volume percentage of CO2 in exhaled air, which is implemented in the method of capnography. The use of capnography is an important element of intensive care. The informativeness of the method of capnography is sufficient for an integrated assessment of the severity of metabolic changes when monitoring the vital functions of patients in ICU with various types of pathology, accompanied by changes in the energy balance of the body and the speed of metabolic processes. The diagnostic value of capnography lies in the method of its continuous implementation, non-invasiveness, relative low cost, as well as the ability to automatically inform the medical staff when registering capnogram values that are critical for the patient. It is advisable to take into account the possibility of including the method of capnography in clinical guidelines and treatment protocols for diseases and conditions requiring controlled correction of metabolic disorders.

capnography, capnogram, sepsis, inflammation, metabolic stress, critical conditions, hypercapnia, hypoxemia, carbon dioxide, ventilation-perfusion relationships