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Korean J Anesthesiol > Volume 41(1); 2001 > Article
Korean Journal of Anesthesiology 2001;41(1):16-22.
DOI: https://doi.org/10.4097/kjae.2001.41.1.16   
A Comparison of Carbon Dioxide Tensions between Arterial Blood and Oxygenator Exhaust Gas during Cardiopulmonary Bypass.
Seong Hoon Ko, Sang Kyi Lee, He Sun Song
1Department of Anesthesiology, Chonbuk National University Medical School, Chonju, Korea.
2Department of Institute of Cardiovascular Research, Chonbuk National University Medical School, Chonju, Korea.
Abstract
BACKGROUND
Maintenance of adequate concentration of carbon dioxide during hypothermic cardiopulmonary bypass is important in order to improve tissue perfusion by maintaining vasodilatation. This study evaluated the usefulness of the analysis of gas sampled from the exhaust port of a membrane oxygenator in the estimation of carbon dioxide tension in arterial blood (PaCO2).
METHODS
One hundred sixty four arterial blood gases were drawn from 45 adult and 30 pediatric cardiac surgical patients undergoing hypothermic cardiopulmonary bypass. Carbon dioxide tensions were measured in the membrane oxygenator exhaust gas (swept gas; PswCO2) using a capnography and in arterial blood using intermittent gas analysis. We compared the PswCO2 with temperature-uncorrected (alpha-stat) and -corrected (pH-stat) PaCO2 during cardiopulmoary bypass.
RESULTS
The mean PaCO2 measured with alpha-stat and pH-stat, and PswCO2 obtained in adult patients during hypothermic cardiopulmonary bypass were 29.8 +/- 4.9, 19.5 +/- 4.1 and 22.3 +/- 4.2 mmHg, respectively. In pediatric patients, alpha-stat PaCO2, pH-stat PaCO2 and PswCO2 were 39.7 +/- 7.7, 24.7 +/- 6.2 and 20.3 +/- 6.0 mmHg, respectively. There was a significant positive correlation between PswCO2 and alpha-stat PaCO2 (adult patients: slope = 0.49, r = 0.64, P < 0.001; pediatric patients: slope = 0.53, r = 0.68, P < 0.001) and pH-stat PaCO2 (adult patients: slope = 0.85, r = 0.81, P < 0.001; pediatric patients: slope = 0.73, r = 0.73, P < 0.001). On comparison of subsequent measurements, 3.8% (adult patients) and 11.4% (pediatric patients) of changes in PaCO2 and PswCO2 were in opposite direction.
CONCLUSIONS
Our results indicate that in adult and pediatric patients undergoing hypothermic cardiopulmonary bypass PswCO2 can be an indicator of changes in trend of PaCO2.
Key Words: Carbon dioxide: monitoring; Heart: cardiopulmonary bypass; Temperature: hypothermia
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