Recent advances in respiratory monitory in nonoperating room anesthesia

Purpose of review Sedation for nonoperating room procedures is experiencing a considerable increase in demand. Respiratory compromise is one of the most common adverse events seen in sedation. Capnography is a modality that has been widely adopted in this area, but may not be well suited to the special demands of nonoperating room sedation. This review is an assessment of new technologies that may improve outcomes beyond those achievable with capnography. Recent findings New devices for detecting the onset of apnea and for assessing respiratory depression have emerged which have advantages over conventional capnography for detecting apnea without excessive false positive and false negative rates. In addition, monitors that assess respiratory drive have become available, and these may prove useful in regulating depth of sedation. Summary No single monitor is ideal for all settings. During brief endoscopic sedation, detection of apnea is paramount, while during longer procedures, avoiding excessive respiratory depression is more critical. The clinician must choose the appropriate monitor based on an understanding of the challenges of the particular environment. Correspondence to Jeff E. Mandel, Assistant Professor of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, 7003 Dulles Building, 3400 Spruce Street, Philadelphia, PA 190103, USA. E-mail: mandelj@uphs.upenn.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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