Excessively Abrupt Increase of ETCO2 Following the Subcutaneous Infiltration of a High Dose of Epinephrine for Intraoperative Hemostasis: A Case Report / 대한마취과학회지

ABSTRACT

End tidal carbon dioxide tension (ETCO2), the partial pressure of exhaled CO2 obtained at the end of tidal breath measured by capnometer, can enable PaCO2 estimation and the monitoring of adequate ventilation. However, there are many factors that may affect ETCO2. Recently, we experienced a patient that developed an abrupt increase of ETCO2 of over 10 mmHg following the subcutaneous infiltration of a high dose of epinephrine for intraoperative hemostasis. This increase in ETCO2 may have been caused by an increased cardiac output and an increase in CO2 production due to increased tissue metabolism. Therefore, when we use ETCO2 to monitor a patient's ventilation, we should bear in mind that three factors - ventilation, hemodynamics and metabolism, may affect the the determined ETCO2 level.