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

Mahajan, Shalvi; Chauhan, Rajeev; Luthra, Ankur; Bala, Indu; Bharti, Neerja; Sharma, Ashish

doi:10.4103/aer.aer_88_19

Cited by 3 publications

References 23 publications

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Difference between arterial and end-tidal carbon dioxide and adverse events after non-cardiac surgery: a historical cohort study

Davis

Jewell

Engoren

et al. 2021

Can J Anesth/J Can Anesth

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The difference between arterial and end-tidal partial pressure of carbon dioxide (DCO 2 ) is a measure of alveolar dead space, commonly evaluated intraoperatively. Given its relationship to ventilation and perfusion, DCO 2 may provide prognostic information and guide clinical decisions. We hypothesized that higher DCO 2 values are associated with occurrence of a composite outcome of reintubation, postoperative mechanical ventilation, or 30-day mortality in patients undergoing non-cardiac surgery. Methods We conducted a historical cohort study of adult patients undergoing non-cardiac surgery with an arterial line at a single tertiary care medical centre. The composite outcome, identified from electronic health records, was reintubation, postoperative mechanical ventilation, or 30-day mortality. Student's t test and Chi-squared test were used for univariable analysis. Logistic regression was used for multivariable analysis of the relationship of DCO 2 with the composite outcome. Results A total of 19,425 patients were included in the final study population. Univariable analysis showed an association between higher mean (standard deviation [SD]) intraoperative DCO 2 values and the composite outcome (6.1 [5.3] vs 5.7 [4.5] mm Hg; P = 0.002). After adjusting for baseline subject characteristics, every 5-mm Hg increase in the DCO 2 was associated with a

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Difference between arterial and end-tidal carbon dioxide and adverse events after non-cardiac surgery: a historical cohort study

Davis

Jewell

Engoren

et al. 2021

Can J Anesth/J Can Anesth

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Transcutaneous carbon dioxide measurements in patients undergoing retroperitoneoscopic urologic surgery: A prospective observational study

Liu

Kong

et al. 2023

Preprint

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Purpose: The aim of the current study was to investigate the accuracy of transcutaneous CO2 pressure (PTCCO2) monitoring and the correlation between it and arterial CO2 pressure (PaCO2), so as to determine PaCO2 in patients undergoing retroperitoneoscopic urologic surgery. Methods: 50 patients undergoing retroperitoneoscopic urologic surgery were enrolled in this study. PaCO2, end-tidal carbon dioxide partial pressure (PETCO2), and PTCCO2 values were measured at 4 time points: before pneumoperitoneum, 30 mins, 60 mins and 90 mins after pneumoperitoneum, respectively. The differences of PaCO2 – PETCO2 and PaCO2 - PTCCO2 were calculated. Paired t test, Bland–Altman method, correlation and regression analysis, as well as Fisher’s exact test were employed for the data analysis. Results: Totally 157 samples were obtained. The mean (SD) of PaCO2, PETCO2 and PTCCO2 were 55.5 (7.2) mmHg, 42.3 (5.2) mmHg and 51.9 (84) mmHg, respectively. The absolute difference of PaCO2－PETCO2 was 13.20 ± 4.43 mmHg and 4.35 ± 2.56 mmHg for PaCO2－PTCCO2 (P < 0.0001). And the correlation coefficient (r) between PaCO2 and PETCO2 was 0.79 (r2 = 0.62, P < 0.0001) , whereas that value between PaCO2 and PTCCO2 was 0.91 (r2 = 0.83, P < 0.0001). Meanwhile, the linear regression between PaCO2 and PETCO2 was PETCO2 = 0.60×PaCO2＋9.10 (P < 0.0001), whilst the counterpart between PaCO2 and PTCCO2 was PTCCO2 = 1.07×PaCO2－7.30 (P < 0.0001). The 95% limits of agreement (LOA) of PaCO2 versus PETCO2 was 4.53 to 21.88 mmHg and -3.18 to 10.48 mmHg for PaCO2 versus PTCCO2. Conclusion: PTCCO2 monitoring provided greater accuracy to estimate PaCO2 in patients undergoing retroperitoneoscopic urologic surgery as compared to PETCO2 .

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Differences Between End-Tidal Carbon Dioxide Obtained in Right and Left Lateral Decubitus Positions in a Patient With a Pulmonary Embolism – A Concept for Usage in Emergency Medicine

et al. 2020

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The aim: To diagnose patients with suspected pulmonary embolism is to assess eTCO2 in two lateral decubitus positions and to compare them between each other and with PaCO2. Material and methods: An approval of the bioethics commission was obtained to study eTCO2 in different positions in patients with suspected PE (583/2019). Consecutive ED patients referred for computed tomography pulmonary angiography (CTPA) due to a suspicion of pulmonary artery embolism are asked to take part in the study. Exclusion criteria are the inability to give informed consent, shock or hypotension, inability to change position (an elevation of the upper body to 30 degrees is allowed). The other available laboratory data like D-dimer concentration, troponin, arterial blood gases analysis, creatinine, sodium, potassium, NT-proBNP, hemoglobin, C-reactive protein, and glycemia are noted. CTPA in the case of pulmonary embolism is assessed to determine differences between embolism to both lungs. Results: The difference between eTCO2 on the left lateral decubitus position was found. Contrary to this finding in a healthy person there was no differences between eTCO2 obtained in both lateral positions. Stress tests are known methods for examining patients whose underlying conditions are normal or inconclusive. In the case of capnography, such a load could be a change in body position, which is a simple procedure that does not require much physical effort. Conclusions: Intensifying efforts to disseminate knowledge on the use of eTCO2 in clinical practice and to find new applications for this study seems particularly important.

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

Cited by 3 publications

References 23 publications

Difference between arterial and end-tidal carbon dioxide and adverse events after non-cardiac surgery: a historical cohort study

Difference between arterial and end-tidal carbon dioxide and adverse events after non-cardiac surgery: a historical cohort study

Transcutaneous carbon dioxide measurements in patients undergoing retroperitoneoscopic urologic surgery: A prospective observational study

Differences Between End-Tidal Carbon Dioxide Obtained in Right and Left Lateral Decubitus Positions in a Patient With a Pulmonary Embolism – A Concept for Usage in Emergency Medicine

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