Peng Yong G, Morey Timothy E, Clark Dale, Forthofer Matthew D, Gravenstein Nikolaus, Janelle Gregory M
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610, USA.
J Cardiothorac Vasc Anesth. 2007 Feb;21(1):57-60. doi: 10.1053/j.jvca.2005.11.022. Epub 2006 Apr 4.
To investigate the relationship between arterial carbon dioxide (PaCO(2)) and mean expired pump CO(2) during cardiopulmonary bypass (PeCPBCO(2)) in patients undergoing cardiac surgery with CPB during steady state, cooling, and rewarming phases of CPB.
Consenting patients, prospective study.
University-affiliated hospital.
Twenty-nine patients.
Patients aged 22 to 81 years were enrolled. An alpha-stat acid-base regimen was performed during CPB. The PeCPBCO(2) was measured by an infrared multigas analyzer with the sampling line connected to the scavenging port of the oxygenator. Values for PaCPBCO(2) from the arterial outflow to the patient and PeCPBCO(2) during CPB at various oxygenator arterial temperatures were collected and compared. Data were analyzed by analysis of variance with 1-way repeated measures and post hoc pair-wise Tukey testing when appropriate. The differences between PaCPBCO(2) and PeCPBCO(2) were linearly regressed against temperature. A p value <0.05 was considered significant.
Three to 5 data sets during CPB were collected from each patient. The mean gradient between PaCPBCO(2) and PeCPBCO(2) was positive 12.4 +/- 10.0 mmHg during the cooling phase and negative 9.3 +/- 9.9 mmHg during the rewarming phase, respectively. On regression of the data, the difference between PaCPBCO(2) and PeCPBCO(2) shows a good correlation with the change in temperature (r(2) = 0.79). The arterial CO(2) +/- x mmHg can be predicted by the formula PaCPBCO(2) = (-2.17x + 69.2) + PeCPBCO(2), where x is temperature in degrees C.
Monitoring the mean expired CO(2) value from the CPB oxygenator exhaust scavenging port with a capnography monitor provides a continuous and noninvasive data source to aid in sweep flow CPB circuit management during CPB.
研究在体外循环（CPB）心脏手术患者的CPB稳态、降温及复温阶段，动脉血二氧化碳分压（PaCO₂）与CPB期间平均呼出泵二氧化碳（PeCPBCO₂）之间的关系。
前瞻性研究，患者自愿参与。
大学附属医院。
29例患者。
纳入年龄在22至81岁的患者。CPB期间采用α稳态酸碱管理方案。通过将采样线连接到氧合器的排气口，使用红外多气体分析仪测量PeCPBCO₂。收集并比较在不同氧合器动脉温度下CPB期间从动脉流出到患者的PaCPBCO₂值和PeCPBCO₂值。数据采用单向重复测量方差分析进行分析，并在适当情况下进行事后两两Tukey检验。将PaCPBCO₂和PeCPBCO₂之间的差异与温度进行线性回归分析。p值<0.05被认为具有统计学意义。
从每位患者收集CPB期间3至5组数据集。在降温阶段，PaCPBCO₂与PeCPBCO₂之间的平均差值分别为正值12.4±10.0 mmHg，在复温阶段为负值9.3±9.9 mmHg。对数据进行回归分析，PaCPBCO₂与PeCPBCO₂之间的差异与温度变化具有良好的相关性（r² = 0.79）。动脉二氧化碳分压（PaCPBCO₂）可通过公式PaCPBCO₂ = (-2.17x + 69.2) + PeCPBCO₂进行预测，其中x为摄氏度温度。
使用二氧化碳监测仪监测CPB氧合器排气口的平均呼出二氧化碳值，可为CPB期间的扫气式CPB回路管理提供连续且无创的数据源。
