Ranucci Marco, Carboni Giovanni, Cotza Mauro, de Somer Filip
1 Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
2 Heart Centre, University Hospital Ghent, Ghent, Belgium.
Perfusion. 2017 Jan;32(1):4-12. doi: 10.1177/0267659116659919. Epub 2016 Jul 18.
Carbon dioxide production during cardiopulmonary bypass derives from both the aerobic metabolism and the buffering of lactic acid produced by tissues under anaerobic conditions. Therefore, carbon dioxide removal monitoring is an important measure of the adequacy of perfusion and oxygen delivery. However, routine monitoring of carbon dioxide removal is not widely applied. The present article reviews the main physiological and pathophysiological sources of carbon dioxide, the available techniques to assess carbon dioxide production and removal and the clinically relevant applications of carbon dioxide-related variables as markers of the adequacy of perfusion during cardiopulmonary bypass.
体外循环期间的二氧化碳产生既源于有氧代谢，也源于组织在无氧条件下产生的乳酸的缓冲作用。因此，监测二氧化碳清除是评估灌注和氧输送是否充足的一项重要指标。然而，常规监测二氧化碳清除并未得到广泛应用。本文综述了二氧化碳的主要生理和病理生理来源、评估二氧化碳产生和清除的现有技术，以及与二氧化碳相关变量在体外循环期间作为灌注充足性标志物的临床相关应用。
