scholarly journals The association between end-tidal carbon dioxide and arterial partial pressure of carbon dioxide after cardiopulmonary bypass pumping in cyanotic children

2021 ◽  
Author(s):  
Behrang Nooralishahi ◽  
Rozhin Faroughi ◽  
Hooman Naghashian ◽  
Ashkan Taghizadeh ◽  
Mohammadjavad Mehrabanian ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiopulmonary Bypass ◽  
Heart Diseases ◽  
Arterial Line ◽  
Blood Gas ◽  
Arterial Pco2 ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Before And After ◽  
End Tidal

Introduction: Evidence suggests the high capability of non-invasive assessment of the End-tidal carbondioxide (ETCO2) in predicting changes in arterial carbon dioxide pressure (PCO2) following major surgeries in children. We aimed to compare EtCO2 values measured by capnography with mainstream device and EtCO2 values assessed by arterial blood gas analysis before and after cardiopulmonary bypass pumping in cyanotic children. Methods: This cross-sectional study was performed on 32 children aged less than 12 years with ASA II suffering cyanotic heart diseases and undergoing elective cardiopulmonary bypass pumping. Arterial blood sample was prepared through arterial line before and after pumping and arterial blood gas (ABG)was analyzed. Simultaneously, the value of EtCO2 was measured by capnography with mainstream device. Results: A significant direct relationship was found between the changes in ETCO2 and arterialPCO2 (r = 0.529, P = 0.029) postoperatively. According to significant linear association between postoperative change in ETCO2 and arterial PCO2, we revealed a new linear formula between the two indices: ΔPCO2 = 0.89× ETCO2-0.54. The association between arterial PCO2 and ETCO2 remained significant adjusted for gender, age, and body weight. Conclusion: the value of ETCO2 can reliability estimate postoperative changes in arterial PCO2 in cyanotic children undergoing cardiopulmonary bypass pumping.

Comparing arterial and end-tidal carbon dioxide values in hyperventilated neurosurgical patients

1995 ◽  
Vol 4 (2) ◽  
pp. 116-121 ◽  
Author(s):  
MA Christensen ◽  
J Bloom ◽  
KR Sutton
Keyword(s):  
Carbon Dioxide ◽  
Carbon Dioxide Tension ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Carbon Dioxide ◽  
Arterial Blood ◽  
Neurosurgical Patients ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Monitoring ◽  
End Tidal

BACKGROUND: Hyperventilation is a frequently used method for inducing hypercarbia in neurosurgical patients. This practice requires careful carbon dioxide monitoring that might be replaced by a less expensive and less invasive alternative to arterial blood gas monitoring. OBJECTIVE: To determine the accuracy of end-tidal carbon dioxide monitoring in hyperventilated neurosurgical patients. METHODS: Nineteen adult patients requiring hyperventilation for the reduction of intracranial pressure following head injury or neurosurgery were enrolled from the surgical intensive care unit of a level I trauma center. A correlation design was used to compare arterial carbon dioxide tensions and end-tidal carbon dioxide measurements during specific periods; secondary analysis with bias and precision estimates was performed. Also, changes in arterial carbon dioxide tensions were compared with simultaneous changes in end-tidal carbon dioxide values. RESULTS: End-tidal carbon dioxide values showed a moderately acceptable correlation with arterial blood gas measurements. However, changes in end-tidal carbon dioxide values failed to correlate with simultaneous changes in arterial carbon dioxide tension measures. Bias and precision measures confirmed these findings. CONCLUSION: In this patient sample, changes in end-tidal carbon dioxide values did not accurately reflect changes in arterial carbon dioxide tension levels in the intensive care setting. Further technological advances in noninvasive carbon dioxide monitoring may lead to a significant cost savings over traditional arterial blood gas analysis.

Validation of transcutaneous carbon dioxide monitoring using an artificial lung during adult pulsatile cardiopulmonary bypass

2021 ◽  
pp. 039139882098785
Author(s):  
Lawrence Garrison ◽  
Jeffrey B Riley ◽  
Steve Wysocki ◽  
Jennifer Souai ◽  
Hali Julick
Keyword(s):  
Carbon Dioxide ◽  
Cardiopulmonary Bypass ◽  
Gold Standard ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Artificial Lung ◽  
Blood Gas ◽  
Median Difference ◽  
Transcutaneous Carbon Dioxide ◽  
Arterial Blood

Measurements of transcutaneous carbon dioxide (tcCO2) have been used in multiple venues, such as during procedures utilizing jet ventilation, hyperbaric oxygen therapy, as well as both the adult and neo-natal ICUs. However, tcCO2 measurements have not been validated under conditions which utilize an artificial lung, such cardiopulmonary bypass (CPB). The purpose of this study was to (1) validate the use of tcCO2 using an artificial lung during CPB and (2) identify a location for the sensor that would optimize estimation of PaCO2 when compared to the gold standard of blood gas analysis. tcCO2 measurements ( N = 185) were collected every 30 min during 54 pulsatile CPB procedures. The agreement/differences between the tcCO2 and the PaCO2 were compared by three sensor locations. Compared to the earlobe or the forehead, the submandibular PtcCO2 values agreed best with the PaCO2 and with a median difference of –.03 mmHg (IQR = 5.4, p < 0.001). The small median difference and acceptable IQR support the validity of the tcCO2 measurement. The multiple linear regression model for predicting the agreement between the submandibular tcCO2 and PaCO2 included the SvO2, the oxygenator gas to blood flow ratio, and the native perfusion index ( R2 = 0.699, df = 1, 60; F = 19.1, p < 0.001). Our experience in utilizing tcCO2 during CPB has demonstrated accuracy in estimating PaCO2 when compared to the gold standard arterial blood gas analysis, even during CO2 flooding of the surgical field.

Clinical evaluation of an instrument to measure carbon dioxide tension at the oxygenator gas outlet in cardiopulmonary bypass

Perfusion ◽  
2006 ◽  
Vol 21 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Frode Kristiansen ◽  
Jan Olav Høgetveit ◽  
Thore H Pedersen
Keyword(s):  
Carbon Dioxide ◽  
Cardiopulmonary Bypass ◽  
Venous Blood ◽  
Carbon Dioxide Tension ◽  
Circuit Board ◽  
Separate Analysis ◽  
Blood Gas ◽  
Arterial Blood ◽  
Gas Measurement ◽  
Venous Blood Gas

This paper presents the clinical testing of a new capno-graph designed to measure the carbon dioxide tension at the oxygenator exhaust outlet in cardiopulmonary bypass (CPB). During CPB, there is a need for reliable, accurate and instant estimates of the arterial blood CO2 tension (PaCO2) in the patient. Currently, the standard practice for measuring PaCO2 involves the manual collection of intermittent blood samples, followed by a separate analysis performed by a blood gas analyser. Probes for inline blood gas measurement exist, but they are expensive and, thus, unsuitable for routine use. A well-known method is to measure PexCO2, ie, the partial pressure of CO2 in the exhaust gas output from the oxygenator and use this as an indirect estimate for PaCO2. Based on a commercially available CO2 sensor circuit board, a laminar flow capnograph was developed. A standard sample line with integrated water trap was connected to the oxygenator exhaust port. Fifty patients were divided into six different groups with respect to oxygenator type and temperature range. Both arterial and venous blood gas samples were drawn from the CPB circuit at various temperatures. Alfa-stat corrected pCO2 values were obtained by running a linear regression for each group based on the arterial temperature and then correcting the PexCO2 accordingly. The accuracy of the six groups was found to be (±SD): ±4.3, ±4.8, ±5.7, ±1.0, ±3.7 and ±2.1%. These results suggest that oxygenator exhaust capnography is a simple, inexpensive and reliable method of estimating the PaCO2 in both adult and pediatric patients at all relevant temperatures.

Feasıbılıty of Transcutaneous Method for Carbon Dıoxıde Monıtorıng in an Intensive Care Unıt

2022 ◽  
Vol 18 ◽  
Author(s):  
Nazlıhan Boyacı ◽  
Sariyya Mammadova ◽  
Nurgül Naurizbay ◽  
Merve Güleryüz ◽  
Kamil İnci ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Partial Pressure ◽  
Blood Gas ◽  
Peripheral Oxygen Saturation ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Randomized Controlled Studies ◽  
Significant Difference

Background: Transcutaneous partial pressure of carbon dioxide (PtCO2) monitorization provides a continuous and non-invasive measurement of partial pressure of carbon dioxide (pCO2). In addition, peripheral oxygen saturation (SpO2) can also be measured and followed by this method. However, data regarding the correlation between PtCO2 and arterial pCO2 (PaCO2) measurements acquired from peripheric arterial blood gas is controversial. Objective: We aimed to determine the reliability of PtCO2 with PaCO2 based on its advantages, like non-invasiveness and continuous applicability. Methods: Thirty-five adult patients with hypercapnic respiratory failure admitted to our tertiary medical intensive care unit (ICU) were included. Then we compared PtCO2 and PaCO2 and both SpO2 measurements simultaneously. Thirty measurements from the deltoid zone and 26 measurements from the cheek zone were applied. Results: PtCO2 could not be measured from the deltoid region in 5 (14%) patients. SpO2 and pulse rate could not be detected at 8 (26.7%) of the deltoid zone measurements. Correlation coefficients between PtCO2 and PaCO2 from deltoid and the cheek region were r: 0,915 and r: 0,946 (p = 0,0001). In comparison with the Bland-Altman test, difference in deltoid measurements was -1,38 ± 1,18 mmHg (p = 0.252) and in cheek measurements it was -5,12 ± 0,92 mmHg (p = 0,0001). There was no statistically significant difference between SpO2 measurements in each region. Conclusion: Our results suggest that PtCO2 and SpO2 measurements from the deltoid region are reliable compared to the arterial blood gas analysis in hypercapnic ICU patients. More randomized controlled studies investigating the effects of different measurement areas, hemodynamic parameters, and hemoglobin levels are needed.

Arterial blood gas tensions during breath-hold diving in the Korean ama

1993 ◽  
Vol 75 (1) ◽  
pp. 285-293 ◽  
Author(s):  
J. Qvist ◽  
W. E. Hurford ◽  
Y. S. Park ◽  
P. Radermacher ◽  
K. J. Falke ◽  
...  
Keyword(s):  
Radial Artery ◽  
Breath Hold ◽  
Blood Gas ◽  
Arterial Pco2 ◽  
Blood Samples ◽  
Arterial Blood Gas ◽  
Time Limits ◽  
Arterial Blood ◽  
Normal Ranges ◽  
Arterial Po2

Korean female unassisted divers (cachido ama) breath-hold dive > 100 times to depths of 3–7 m during a work day. We sought to determine the extent of arterial hypoxemia during normal working dives and reasonable time limits for breath-hold diving by measuring radial artery blood gas tensions and pH in five cachido ama who dove to a fixed depth of 4–5 m and then continued to breath hold for various times after their return to the surface. Eighty-two blood samples were withdrawn from indwelling radial artery catheters during 37 ocean dives. We measured compression hyperoxia [arterial PO2 = 141 +/- 24 (SD) Torr] and hypercapnia (arterial PCO2 = 46.6 +/- 2.4 Torr) at depth. Mean arterial PO2 near the end of breath-hold dives lasting 32–95 s (62 +/- 14 s) was decreased (62.6 +/- 13.5 Torr). Mean arterial PCO2 reached 49.9 +/- 5.4 Torr. Complete return of these values to their baseline did not occur until 15–20 s after breathing was resumed. In dives of usual working duration (< 30 s), blood gas tensions remained within normal ranges. Detailed analysis of hemoglobin components and intrinsic oxygenation properties revealed no evidence for adaptive changes that could increase the tolerance of the ama to hypoxic or hypothermic conditions associated with repetitive diving.

scholarly journals Severe hypoxaemia in field-anaesthetised white rhinoceros (Ceratotherium simum) and effects of using tracheal insufflation of oxygen

2004 ◽  
Vol 75 (2) ◽  
Author(s):  
M. Bush ◽  
J.P. Raath ◽  
D. Grobler ◽  
L. Klein
Keyword(s):  
Blood Pressure ◽  
Tracheal Intubation ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
White Rhinoceros ◽  
Severe Hypoxaemia ◽  
Before And After ◽  
Tracheal Insufflation ◽  
Free Ranging

White rhinoceros anaesthetised with etorphine and azaperone combination develop adverse physiological changes including hypoxia, hypercapnia, acidosis, tachycardia and hypertension. These changes are more marked in field-anaesthetised rhinoceros. This study was designed to develop a technique to improve safety for field-anaesthetised white rhinoceros by tracheal intubation and oxygen insufflation. Twenty-five free-ranging white rhinoceros were anaesthetised with an etorphine and azaperone combination for translocation or placing microchips in their horns. Once anaesthetised the rhinoceros were monitored prior to crating for transportation or during microchip placement. Physiological measurements included heart and respiratory rate, blood pressure and arterial blood gas samples. Eighteen rhinoceros were intubated using an equine nasogastric tube passed nasally into the trachea and monitored before and after tracheal insufflation with oxygen. Seven rhinoceros were not intubated or insufflated with oxygen and served as controls. All anaesthetised rhinoceros were initially hypoxaemic (percentage arterial haemoglobin oxygen saturation (% O2Sa) = 49 % + 16 (mean + SD) and PaO2 = 4.666 + 1.200 kPa (35 + 9 mm Hg)), hypercapnic (PaCO2 = 8.265 + 1.600 kPa (62 + 12 mm Hg)) and acidaemic (pHa = 7.171 + 0.073 ). Base excess was -6.7 + 3.9 mmol/ℓ, indicating a mild to moderate metabolic acidosis. The rhinoceros were also hypertensive (systolic blood pressure = 21.861 + 5.465 kPa (164 + 41 mm Hg)) and tachycardic (HR = 107 + 31/min). Following nasal tracheal intubation and insufflation, the % O2Sa and PaO2 increased while blood pHa and PaCO2 remained unchanged.Tracheal intubation via the nose is not difficult, and when oxygen is insufflated, the PaO2 and the % O2Sa increases, markedly improving the safety of anaesthesia, but this technique does not correct the hypercapnoea or acidosis. After regaining their feet following reversal of the anaesthesia, the animals' blood gas values return towards normality.

Sign in / Sign up

Export Citation Format

Share Document