Arterial to end-tidal CO2 gradients during isocapnic hyperventilation
Authors' conclusion
The effect of a modest rise of PICO2 up to 1.5% on PETCO2 during RARP can be readily overcome by increasing ventilation without altering the Pa-ETCO2 gradients.
Study context
- Population
- ASA PS I–II subjects undergoing robot-assisted radical prostatectomy or cystectomy under general endotracheal anesthesia with sevoflurane in O2/air1 subject excluded from analysis · or cystectomy 1
- Participants
- 12 subjects
- Exposure
- Pa-ETCO2 gradients at PICO2 0, 0.5, 1.0, 1.5 and 2%
- Outcome
- Pa-ETCO2 gradient, with ventilation increased (respiratory rate) to a target PETCO2 of 4.7-4.9%
- Follow-up
- After a 15 min equilibration period at each PICO2 level
Methodological detailssequential PICO2 increments, isocapnic hyperventilation
- Sequential PICO2 increments
- Isocapnic hyperventilation
Main finding
As reported in the abstract
Pa-ETCO2 gradients
- Pa-ETCO2 gradients did not change when PICO2 increased
- Compared using ANOVA
Observational data: associations, not effects.
Further findings
Maintenance of PETCO2 within 4.7-4.9%
- PETCO2 maintained in all subjects at all times except subjects with 1.5% PICO2
- 1
- PETCO2 maintained in all subjects at all times except subjects with 2.0% PICO2
- 5
- Data from the one subject in whom both 1.5 and 2.0% PICO2 resulted in PETCO2 > 5.1% were excluded from analysis
Safety
- Capnograms were normal and hemodynamic parameters remained stable
Original publication
Arterial to end-tidal CO2 gradients during isocapnic hyperventilation. J Clin Monit Comput. Published 27 July 2022. doi:10.
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