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Enhancing Patient Safety
in Veterinary Anesthesia:
The Critical Role of Capnography

Samantha Michaelis, Marketing Manager, Midmark Veterinary

By: Mandi Gerigk CVT, BAS
August 2025
Clinical Specialist, Monitoring and Critical Care

 

 

Veterinary medicine has become increasingly sophisticated, with practices embracing technologies that elevate safety and confidence. Among these, capnography, particularly waveform capnography, stands out as a non-negotiable tool for monitoring anesthetized patients. By using capnography to measure patient ventilation, veterinary teams receive a real-time snapshot of a patient’s respiratory and metabolic status, often detecting emergencies before other parameters.

 

What Is Capnography—And Why Does It Matter?

Capnography is a real-time measurement and graphical display of the concentration of CO₂ in each breath. Unlike pulse oximetry, which measures the oxygen saturation of hemoglobin, capnography reflects the patient’s ventilation, perfusion and metabolism simultaneously, making it indispensable in anesthetic monitoring.

Capnography became a standard of care in human medicine after a landmark closed-claim analysis in the late 1980s found that the combined use of capnometry and pulse oximetry could have helped prevent 93% of anesthetic-related injuries or deaths.1 The implication for veterinary care is clear: this tool is not optional—it’s essential.

 

 

Midmark Multiparameter Monitor 12 and 8 inch

 

 

Detecting Anesthetic Complications Early

Changes in the capnogram waveform can serve as an early indication of emerging issues. Veterinary teams trained to interpret these variations can promptly identify many conditions, some of which are potentially life-threatening, including:

Hypoventilation:
Indicated by a gradual rise in CO₂, suggesting insufficient respiratory rate or depth.

Hyperventilation:
Characterized by abnormally low EtCO₂ levels.

Rebreathing of CO₂:
Typically due to exhausted CO₂ absorbent, excessive dead space or circuit malfunction.

Esophageal intubation:
Where the endotracheal tube is incorrectly placed, resulting in absent or inconsistent waveforms.

Leaking:
Leakage from the ETT cuff causes a waveform that never reaches the full plateau.

Cardiac output changes:
Monitoring trends showing a decreasing EtCO₂ may indicate a decline in cardiac output. An early sign of impending cardiac arrest.

Effectiveness of chest compressions during CPR:
Maintaining EtCO₂ values above 18 mmHg ensures effective chest compressions. A sudden spike in EtCO₂ often indicates ROSC.

 

 

 

 

Empower Your Team

Recognizing and interpreting abnormal capnograms requires training, but even experienced teams benefit from decision support. Some monitoring systems now integrate a CO₂ waveform library, which allows veterinary professionals to match a patient’s capnogram with a visual reference to common complications. Proper equipment plays a key role in this support. Midmark Multiparameter Monitors feature both mainstream and sidestream capnography, along with integrated CO₂ waveform libraries to help teams identify patterns and troubleshoot in real time.

But equipment alone isn't enough. To truly empower your team, hands-on training is essential. Interpreting capnography data—and knowing how to respond in the moment—should be considered a core competency. The Midmark Academy Anesthesia Simulation Workshop allows your team to practice anesthesia and monitoring skills, including common complications, in a controlled setting that helps build confidence and shared decision-making before applying those skills in live patient care.

 

 

Sidestream or Mainstream Capnography?

Learn more about each in this quick guide written to help you choose the right approach for your patients and workflow.

LEARN MORE

 

 

Final Thoughts: Supporting Clinical Excellence

Capnography is a powerful tool, but its true value lies in the hands of skilled anesthetists who understand what the numbers and waveforms represent and what to do when they change. With proper training, capnography gives you the insight to recognize complications earlier, have more confidence and continue improving outcomes for your patients.

 

 

 

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Sources

1. Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW. Role of monitoring devices in prevention of anesthetic mishaps: a closed claims analysis. Anesthesiology. 1989;71(4):541-546. https://journals.lww.com/anesthesiology/citation/1989/10000/role_of_monitoring_devices_in_prevention_of.10.aspx