Effect of Patient Weight and Anesthetic Technique on CO₂ Excretion During Thoracoscopy in Children Assessed by End-Tidal CO₂

Abstract

There is a significant increase in EtCO(2) in children undergoing thoracoscopy, which is higher than during laparoscopy. Changes in EtCO(2) are larger in smaller children undergoing single-lung ventilation. Thoracoscopy may preserve intraoperative thermoregulation.

Decreased cerebral oxygen saturation during thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia in infants

“…These effects may be reduced by using lower insufflation pressures. It has been demonstrated that small children eliminate relatively more CO 2 during pneumoperitoneum or pneumothorax and thus require scrupulous anesthetic management [10,11]. Breath CO 2 could originate from metabolically produced CO 2 or from absorption of insufflation gas.…”

Thoracoscopic repair of congenital diaphragmatic hernia: intraoperative ventilation and recurrence

“…However, there are instances where extra vigilance is required. Younger, smaller children have been shown to have larger changes in EtCO 2 and/or CO 2 elimination during both laparoscopy [11] and thoracoscopy [8]. Neonates are therefore particularly vulnerable.…”

“…Coupled with impaired ventilation, this can lead to a marked increase in end-tidal CO 2 (EtCO 2 ) in children undergoing thoracoscopy, which is generally higher than that seen during laparoscopy and in smaller children undergoing single lung ventilation [8].…”

Minimally invasive surgery in neonates

“…Anestezistin yapacağı en iyi yol hiperventilasyondur. Torakoskopi esnasında masif karbondioksit absorbsiyonu sonucu nörotoksik etkiler gözlenmiştir (9,10) . Laparoskopide karın içi basıncın artmasıyla böbrek fonksiyonları etkilenebilmektedir.…”