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

Behrang Nooralishahi,Hooman Naghashian,Mehdi Dehghani Firoozabadi,Rozhin Faroughi,Mohammadjavad Mehrabanian,Ashkan Taghizadeh

doi:10.34172/jcvtr.2021.49

Abstract

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.

Highlights

Evidence suggests the high capability of non-invasive assessment of the Endtidal carbon dioxide (ETCO2) in predicting changes in arterial carbon dioxide pressure (PCO2) following major surgeries in children
We aimed to compare End-tidal CO2 (EtCO2) values measured by capnography with mainstream device and PaCO2 values assessed by arterial blood gas analysis before and after cardiopulmonary bypass pump in cyanotic children
The results related to association of the postoperative change in ETCO2 and changing other study parameters (Table 2) showed only a significant direct relationship between ETCO2 and arterial PCO2 (r = 0.529, p = 0.029)

Summary

Introduction

Evidence suggests the high capability of non-invasive assessment of the Endtidal carbon dioxide (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. Conclusion: the value of ETCO2 can reliability estimate postoperative changes in arterial PCO2 in cyanotic children undergoing cardiopulmonary bypass pumping. Continuous measurement of EtCO2 is one of the methods used in the operating room for evaluation of hemodynamic state during general anesthesia and in intubated patients It can even be a noninvasive, fast and reliable method for predicting PaCo2 in non-intubated patients.[2,3] This measurement makes it possible to estimate arterial PaCo2 without the need for arterial blood sampling. If there is a constant relationship between PaCo2 and EtCO2, this method is reliable and there is no need for frequent arterial blood extraction. The association between EtCO2 and PaCO2 has been established, but the accuracy of this method is still debated.[4,5,6,7] In a study comparing the relationship between EtCO2 and PaCO2 in the prone and supine positions, it was found that under normal circumstances, EtCO2 is a useful tool for monitoring PaCO2, but its accuracy may decrease when using different surgical techniques and in different positions.[8]

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Conclusion