Capnography Monitoring During Neurosurgery

Grenier, B.; Verchère, Eric; Mesli, A.; Dubreuil, M.; Siao, D.; Vandendriessche, Monique; Cales, J; Maurette, P.

doi:10.1097/00000539-199901000-00009

Cited by 18 publications

(5 citation statements)

References 19 publications

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“…[13] Patient positioning has also been shown to have an impact on the accuracy of ET-CO 2 monitoring. [23] With patients undergoing renal or upper ureteral surgery in the supine position, Pansard et al reported that the ET-CO 2 to PaCO 2 difference was 4.8 ± 3.9 mmHg 10 min after induction and increased to 7.9 ± 3.5 mmHg ( P <0.01) 5 min after placement of the patients into the lateral decubitus ‘kidney rest’ position. Similar results were reported by Grenier et al in a cohort of patients undergoing neurosurgical procedures in the lateral decubitus position.…”

Section: Discussionmentioning

confidence: 99%

“…Similar results were reported by Grenier et al in a cohort of patients undergoing neurosurgical procedures in the lateral decubitus position. [3]…”

Section: Discussionmentioning

confidence: 99%

“…However, various factors, including patient positioning, sampling errors and ventilation-perfusion mismatch due to dead space or shunt, may significantly affect the arterial to ET-CO 2 gradient. [1–3]…”

mentioning

confidence: 99%

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Noninvasive monitoring of PaCO₂ during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Cox

Tobias

2007

J Min Access Surg

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Background:Previous studies have suggested that end-tidal CO2 (ET-CO2) may be inaccurate during one-lung ventilation (OLV). This study was performed to compare the accuracy of the noninvasive monitoring of PCO2 using transcutaneous CO2 (TC-CO2) with ET-CO2 in patients undergoing video-assisted thoracoscopic surgery (VATS) during OLV.Materials and Methods:In adult patients undergoing thoracoscopic surgical procedures, PCO2 was simultaneously measured with TC-CO2 and ET-CO2 devices and compared with PaCO2.Results:The cohort for the study included 15 patients ranging in age from 19 to 71 years and in weight from 76 to 126 kg. During TLV, the difference between the TC-CO2 and the PaCO2 was 3.0 ± 1.8 mmHg and the difference between the ET-CO2 and PaCO2 was 6.2 ± 4.7 mmHg (P=0.02). Linear regression analysis of TC-CO2 vs. PaCO2 resulted in an r2 = 0.6280 and a slope = 0.7650 ± 0.1428, while linear regression analysis of ET-CO2 vs. PaCO2 resulted in an r2 = 0.05528 and a slope = 0.1986 ± 0.1883. During OLV, the difference between the TC-CO2 and PaCO2 was 3.5 ± 1.7 mmHg and the ET-CO2 to PaCO2 difference was 9.6 ± 3.6 mmHg (P=0.03 vs. ET-CO2 to PaCO2 difference during TLV; and P<0.0001 vs. TC-CO2 to PaCO2 difference during OLV). In 13 of the 15 patients, the TC-CO2 value was closer to the actual PaCO2 than the ET-CO2 value (P =0.0001). Linear regression analysis of TC-CO2 vs. PaCO2 resulted in an r2 = 0.7827 and a slope = 0.8142 ± 0.0.07965, while linear regression analysis of ET-CO2 vs. PaCO2 resulted in an r2 = 0.2989 and a slope = 0.3026 ± 0.08605.Conclusions:During OLV, TC-CO2 monitoring provides a better estimate of PaCO2 than ET-CO2 in patients undergoing VATS.

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Section: Discussionmentioning

confidence: 99%

“…Similar results were reported by Grenier et al in a cohort of patients undergoing neurosurgical procedures in the lateral decubitus position. [3]…”

Section: Discussionmentioning

confidence: 99%

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Noninvasive monitoring of PaCO₂ during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Cox

Tobias

2007

J Min Access Surg

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“…The correlation of EtCO 2 and PaCO 2 has been reported to be unreliable in some clinical situations, and no correlation was found between EtCO 2 and PaCO 2 when the physiologic dead space was substantially elevated ( 13 - 19 ). Physiologic dead space ventilation is the sum of the anatomic dead space from the conducting airways and the alveolar dead space arising from a disease process and/or therapy.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Measurement of End-tidal CO<sub>2</sub> Using a Portable Capnometer in Patients with Chronic Respiratory Failure Receiving Long-term Oxygen Therapy

Inomata

Takada

et al. 2020

Intern. Med.

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Objective Patients with chronic respiratory failure requiring long-term oxygen therapy (LTOT) are at a risk of CO2 retention because of excessive oxygen administration. The CapnoEye™ is a novel portable capnometer that can measure end-tidal CO2 (EtCO2) noninvasively. This retrospective study evaluated the usefulness of this device. Methods EtCO2 was measured using the CapnoEye. The EtCO2 and partial pressure of venous carbon dioxide (PvCO2) were analyzed, and other clinical data were assessed. Patients Sixty-one consecutive patients with chronic respiratory failure receiving LTOT in the outpatient department at the Japanese Red Cross Medical Center between July 2017 and March 2018 were retrospectively reviewed. Results There was a significant correlation between EtCO2 and PvCO2 (r=0.63) in the total study population as well as in the COPD group (r=0.65) and ILD group (r=0.67). The PvCO2 and EtCO2 gradient was correlated with only the body mass index in a multivariate analysis (p=0.0235). The EtCO2 levels on the day of admission were significantly higher than those in the same patients when they were in a stable condition (p= 0.0049). There was a significant correlation between ΔEtCO2 and ΔPvCO2 (r=0.4). A receiver-operating characteristic curve analysis revealed the optimal cutoff EtCO2 value for identifying hypercapnia to be 34 mmHg (p=0.0005). Conclusion The evaluation of EtCO2 by the CapnoEye was useful for predicting PvCO2. The body mass index was identified as a possible predictor of the PvCO2 and EtCO2 gradient. An increase in EtCO2 may indicate deterioration of the respiratory status in patients with chronic respiratory failure receiving LTOT.

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“…Both PEtCO 2 and PaCO 2 showed a significant rise from the supine position. Grenier et al [12] recorded a significantly higher P (a-Et) CO 2 gradient in neurosurgical patients operated in LDP in compared to those who were operated in the supine position (7 ± 3 mmHg vs. 6 ± 3 mmHg in lateral vs. supine position, P < 0.05). Similarly, Pansard et al [13] found a significant increase in P (a-Et) CO 2 gradient 5 min after LDP in comparison to the supine position (7.9 ± 3.5 mmHg vs. 4.8 ± 3.9 mmHg in lateral vs. supine position P < 0.05) in patients undergoing renal surgery in the LDP.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of arterial to end-tidal carbon dioxide pressure differences during laparoscopic renal surgery in the lateral decubitus position

et al. 2019

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Background:End-tidal carbon dioxide (PEtCO2) is a noninvasive reliable technique to measure arterial partial pressure of carbon dioxide (PaCO2) in the body under general anesthesia. However, gradient between PaCO2 and PEtCO2 (P[a-Et] CO2) is influenced by many factors.Aims:In the present study, we evaluated the changes in P (a-Et) CO2 for laparoscopic donor nephrectomy in lateral decubitus position (LDP).Settings and Design:This was an observational, double-blinded, tertiary care center-based study.Methods:Thirty-one American Society of Anesthesiologists Class I and Class II patients of either sex undergoing laparoscopic donor nephrectomy in LDP under general anesthesia were included. An arterial cannula was inserted, PaCO2 was measured at eight predesignated time intervals, and PEtCO2 was also noted at the corresponding time period.Statistical Analysis:Data were analyzed using a two-way analysis of variance for repeated measurements using one dependent variable and one within-subject factor (time). Quantitative data were presented as mean ± standard deviation or median and interquartile range, as appropriate.Results:The mean P (a-Et) CO2 gradient was 5.67 ± 1.36 mmHg 10 min after induction of anesthesia in the supine position (T1a). Ten minutes after LDP, P (a-Et) CO2 gradient was 7.38 ± 1.45 mmHg (T1b) and was higher than T1a. The P (a-Et) CO2 values 10 min after release of pneumoperitoneum and 10 min after making the patient supine were significantly higher than the T1a value. The highest value of P (a-Et) CO2 gradient was at 30 min after creation of pneumoperitoneum (T30), i.e., 9.99 ± 1.70 mmHg. Pearson's correlation coefficient showed that the degree of correlation varied considerably during surgery due to interindividual variability (R2 T1a vs. T60 was 0.61 vs. 0.17).Conclusions:PEtCO2 does not reliably predict PaCO2 in healthy patients scheduled for laparoscopic renal surgery in LDP.

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Capnography Monitoring During Neurosurgery

Cited by 18 publications

References 19 publications

Noninvasive monitoring of PaCO₂ during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Noninvasive monitoring of PaCO₂ during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Usefulness of Measurement of End-tidal CO<sub>2</sub> Using a Portable Capnometer in Patients with Chronic Respiratory Failure Receiving Long-term Oxygen Therapy

Evaluation of arterial to end-tidal carbon dioxide pressure differences during laparoscopic renal surgery in the lateral decubitus position

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Capnography Monitoring During Neurosurgery

Cited by 18 publications

References 19 publications

Noninvasive monitoring of PaCO2 during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Noninvasive monitoring of PaCO2 during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Usefulness of Measurement of End-tidal CO<sub>2</sub> Using a Portable Capnometer in Patients with Chronic Respiratory Failure Receiving Long-term Oxygen Therapy

Evaluation of arterial to end-tidal carbon dioxide pressure differences during laparoscopic renal surgery in the lateral decubitus position

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Noninvasive monitoring of PaCO₂ during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques

Noninvasive monitoring of PaCO₂ during one-lung ventilation and minimal access surgery in adults: End-tidal versus transcutaneous techniques