Capnography: Made Simple

A Quick Guide for Student + Registered Veterinary Nurses ✨

Capnography is one of the most useful monitoring tools we have in practice - especially during anaesthesia! It gives us real-time information about how well our patient is breathing + circulating.

✨ What is capnography?

Capnography is a non-invasive way of measuring carbon dioxide (CO2) in the air a patient breathes in and out.

It shows us this information as a waveform (capnogram) over time.

✨ What does a normal capnogram look like?

A normal capnogram follows a simple pattern:

  • CO2 starts at zero (which is the baseline)
  • it rises during expiration
  • reaches a plateau (alveolar plateau)
  • then drops back to zero on inspiration 

Think - up on breathing out, down on breathing in

✨ Common capnography patterns

Airway obstruction ("shark-fin")

  • waveform looks slanted instead of square
  • possible causes: mucous in ET tube, bronchospasm

Cardiogenic oscillations

  • small wavy ripples on the plateau
  • seen in - brachycephalic patients, barrel-chested patients, low respiratory rates

Hypercapnia (high CO2)

  • increased ETCO2 values 
  • possible causes: hypoventilation, increased CO2 production, increased cardiac output

Decreasing ETCO2

  • can be: gradual (leaks, hyperventilation) or sudden (disconnection, early signs of arrest)

Rebreathing

  • waveform doesn't return to baseline
  • possible causes: low fresh gas flow rate, exhausted soda lime, excessive dead space

✨ Why capnography matters

Capnography helps you quickly assess:

  • ventilation
  • airway patency
  • equipment issues
  • early signs of patient deterioration 

✨ Quick takeaway

Normal = square wave, returns to zero

"Shark-fin" = obstruction 

High CO2 = hypoventilation

Low CO2 = check patient/equipment

No baseline = rebreathing

I really hope this helps! For a quick-reference version, you can purchase my 'capnography' poster here:

https://thatvetnurselife.co.uk/products/veterinary-nurse-capnography-poster-anaesthesia-study-aid?_pos=1&_psq=capno&_ss=e&_v=1.0

Thank you so much for reading, Jade x

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