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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
MIYAJI, Karina Takesaki et al. Correlation between end-tidal carbon dioxide levels and cardiac output during cardiac surgery with cardiopulmonary bypass. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.5, pp.625-633. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942004000500002.
BACKGROUND AND OBJECTIVES: End-tidal carbon dioxide (PETCO2) not only reflects pulmonary ventilation but also carbon dioxide production (metabolism) and pulmonary blood supply (circulation). During constant metabolism and ventilation, PETCO2 reflects pulmonary blood perfusion, thus cardiac output (CO). This study aimed at evaluating the correlation between PETCO2 levels and CO during cardiac surgery with cardiopulmonary bypass (CPB). METHODS: Participated in this study 25 patients submitted to coronary artery bypass grafting (CABG) with CPB. End-tidal CO2 monitoring started after tracheal intubation. Cardiac output was determined by thermodilution with pulmonary artery catheter (Swan-Ganz). Carbon dioxide partial blood pressure (PaCO2) was obtained with arterial blood gases analysis. Studied parameters were evaluated in the following moments: immediately after general anesthesia induction, before cardiopulmonary bypass, at cardiopulmonary bypass completion and at surgery completion. RESULTS: Statistical analysis has not shown correlation between PETCO2 and CO2, or between PETCO2-PaCO2 gradient (Ga-eCO2) and CO. There has been correlation between PETCO2, Ga-eCO2 and CO values variation as compared to baseline values before CPB, with loss of correlation after CPB until surgery completion. CONCLUSIONS: In this study, where patients submitted to cardiac surgery with CPB were evaluated, ventilation/perfusion changes throughout the procedure might have been the factors determining decreased correlation between cardiac output and end tidal CO2.
Keywords : MONITORIZATION [end-tidal carbon dioxide]; MONITORIZATION [cardiac output]; SURGERY [Cardiac].