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Arterial and end-tidal Carbon Dioxide in Supine Obese Patients during General Anesthesia

Open Journal of Anesthesiology 2015年第5期5卷 79-84页

作者： Kenichi Satoh Mami Chikuda Ayako Ohashi Miho Kumagai Masahito Sato Akiyoshi Kuji Shigeharu Joh Division of Dental Anesthesiology Department of Reconstructive Oral and Maxillofacial Surgery School of Dentistry Iwate Medical University Morioka Japan Division of Special Care Dentistry Department of Developmental Oral Health Science School of Dentistry Iwate Medical University Morioka Japan

Background: We investigated the differences between partial pressure of arterial carbon dioxide and end-tidal carbon dioxide (P(a-ET)CO2) with respect to the Broca-Katsura index (BKI), which is an obesity index, in obese patients during general anesthesia. Materials and Methods: From January 2003 to December 2013, we studied 601 patients aged 16 years old or over undergoing general anesthesia. Patients had American Society of Anesthesiology physical status I and II and we reviewed their anesthetic charts. The P(a-ET)CO2 with respect to the BKI divided patients into two groups: 16 to 2 values between the two groups. Results: In patients aged 16 to 2 was 2.2 ± 3.1 mmHg at BKI 2 was 3.2 ± 4.1 mmHg at BKI 2 tends to increase in obese patients during general anesthesia with increasing BKI in patients aged 16 to < 65 years old.

关键词： Arterial-Alveolar Carbon Dioxide Tension Difference Broca-Katsura Index end-tidal Carbon Dioxide Partial Pressure of Arterial Carbon Dioxide Supine Position

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Preliminary Validation of Transcutaneous CO<sub>2</sub>Monitoring in Patients Undergoing Cardiac Ablation Using Jet Ventilation

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Open Journal of Anesthesiology 2017年第9期7卷 315-327页

作者： Zvi C. Jacob Roger Fan Ruth A. Reinsel Nehul Patel Arvind Chandrakantan Department of Anesthesiology Stony Brook Medicine Stony Brook NY USA Division of Cardiology Department of Medicine Stony Brook Medicine Stony Brook NY USA Current Address: Department of Anesthesiology Texas Children’s Hospital Houston TX USA

Objectives: There is no data in the current medical literature on efficacy or accuracy of transcutaneous (tcPCO2) monitoring during jet ventilation for cardiac ablation. The use of tcPCO2 during cardiac ablation procedures offers the opportunity to compare end-tidal and transcutaneous methods of CO2 measurement before and after the use of the jet ventilation. Comparison of these measurements with arterial blood gas CO2 levels allows evaluation of the accuracy of the tcPCO2 technique for use during jet ventilation. Design: Observational study;patients served as their own controls. Setting: Cardiac electrophysiology laboratory. Participants: 15 adult patients (9 M), ASA III-IV, aged 26 to 82 years (median 66 years) undergoing radiofrequency ablation for atrial fibrillation. Interventions: Jet ventilation (JV) versus conventional ventilation. Measurements and Main Results: Paired measurements of end-tidal CO2 (EtCO2) and transcutaneous CO2 (tcPCO2) were recorded during periods of conventional ventilation. Paired measurements of arterial blood CO2 (PaCO2) levels and tcPCO2 were recorded during JV. ABG samples were drawn at the anesthesiologist’s discretion to assess the patient’s respiratory status. The level of agreement between the three methods was compared using the Bland Altman plot. We found that tcPCO2 values consistently provided a close approximation to PaCO2 levels. The mean difference between tcPCO2 and EtCO2 values in baseline and post-JV was on the order of 3 - 5 mmHg, with standard deviation of 4 - 6 mmHg. This is well within the range of variability that is accepted in clinical practice. Conclusions: These preliminary results suggest that tcPCO2 provides an acceptable estimate of CO2 concentration in arterial blood during JV, as well as prior to and following JV.

关键词： High Frequency Jet Ventilation Cardiac Ablation Transcutaneous CO2 Monitoring end-tidal CO2 Monitoring General Anesthesia

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