An abrupt reduction in end tidal carbon di oxide concentration in a mechanically ventilated patient in neurocritical care ward: a capnogram artifact.

In patients with normal lung and reasonable cardiac function such as head injury patients, the PETCo2 can be used as a surrogate for partial pressure of Carbon dioxide (PaCO2) in mechanically ventilated patients. Thus early interpretation and accurate assessment of capnogram is crucial in neurocritical care patients. Here we present and discuss a scenario where in connection of a jet nebulizer to the ventilator lead to abrupt decrease in end tidal carbon dioxide leading to a diagnostic dilemma. Also this report highlights and discusses the importance of the proper placement of breathing circuit components to ensure accurate CO2 readings in particular the use of a jet nebulizer.