Journal of cardiothoracic and vascular anesthesia · 2025
Comparison of Arterial Partial Pressure of Carbon Dioxide with That at Oxygenator Exhaust During Cardiopulmonary Bypass for Pediatric Cardiac Surgery.
СтатьяНаблюдательное исследованиеСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Devarakonda Bhargava V, Gadhinglajkar Shrinivas V, Vadapalli Kiranmai, Sukesan Subin, Sreedhar Rupa, Dharan Baiju S
Аннотация
OBJECTIVE: To evaluate whether carbon dioxide tension (PeCO₂) derived from oxygenator exhaust capnography is comparable to temperature-corrected arterial partial pressure of carbon dioxide (PaCO₂) measured via blood gas analysis during mild hypothermic cardiopulmonary bypass (CPB) in pediatric patients undergoing elective cardiac surgery.
DESIGN: A prospective observational study.
SETTING: A tertiary care hospital with a specialized pediatric cardiac surgery unit.
PARTICIPANTS: Eighty paired measurements of PeCO₂ and PaCO₂ were obtained from 40 pediatric patients (aged between 1 and 12 years) undergoing elective cardiac surgery for biventricular repair with stable mild hypothermic CPB using a membrane oxygenator.
INTERVENTIONS: No interventions were performed. The study involved continuous measurement of PeCO₂ from the oxygenator exhaust and periodic arterial blood gas analysis to assess PaCO₂ during stable mild hypothermia.
MEASUREMENTS AND MAIN RESULTS: A Bland-Altman analysis was conducted to determine the agreement between PeCO₂ and temperature-corrected PaCO₂. The correlation coefficient was 0.81, with a bias of 0.036, standard deviation of 2.76, and limits of agreement ranging from -5.37 to 5.44. A linear regression equation was established: temperature-corrected PaCO₂ = 0.71 × PeCO₂ + 8.28. No significant correlation was observed between PeCO₂ and temperature-uncorrected PaCO₂.
CONCLUSIONS: Under stable mild hypothermic CPB conditions, PeCO₂ demonstrates a strong correlation with temperature-corrected PaCO₂ and can be predicted using a simple linear equation in pediatric patients undergoing elective cardiac surgery. Oxygenator exhaust capnography may serve as a continuous, cost-effective, non-invasive, pragmatic surrogate for PaCO₂ monitoring during a stable hypothermic CPB period in the pediatric population undergoing elective cardiac surgery.
DESIGN: A prospective observational study.
SETTING: A tertiary care hospital with a specialized pediatric cardiac surgery unit.
PARTICIPANTS: Eighty paired measurements of PeCO₂ and PaCO₂ were obtained from 40 pediatric patients (aged between 1 and 12 years) undergoing elective cardiac surgery for biventricular repair with stable mild hypothermic CPB using a membrane oxygenator.
INTERVENTIONS: No interventions were performed. The study involved continuous measurement of PeCO₂ from the oxygenator exhaust and periodic arterial blood gas analysis to assess PaCO₂ during stable mild hypothermia.
MEASUREMENTS AND MAIN RESULTS: A Bland-Altman analysis was conducted to determine the agreement between PeCO₂ and temperature-corrected PaCO₂. The correlation coefficient was 0.81, with a bias of 0.036, standard deviation of 2.76, and limits of agreement ranging from -5.37 to 5.44. A linear regression equation was established: temperature-corrected PaCO₂ = 0.71 × PeCO₂ + 8.28. No significant correlation was observed between PeCO₂ and temperature-uncorrected PaCO₂.
CONCLUSIONS: Under stable mild hypothermic CPB conditions, PeCO₂ demonstrates a strong correlation with temperature-corrected PaCO₂ and can be predicted using a simple linear equation in pediatric patients undergoing elective cardiac surgery. Oxygenator exhaust capnography may serve as a continuous, cost-effective, non-invasive, pragmatic surrogate for PaCO₂ monitoring during a stable hypothermic CPB period in the pediatric population undergoing elective cardiac surgery.