Arterial to end-tidal carbon dioxide pressure gradient increases with age in the steep Trendelenburg position with pneumoperitoneum / 대한마취과학회지
Korean Journal of Anesthesiology
; : 209-215, 2012.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-187713
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Several factors affect the end-tidal carbon dioxide pressure (PETCO2) and increase the arterial to end-tidal carbon dioxide pressure gradient (Pa-ETCO2) during general anesthesia. We evaluated the relationship between age and Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position in patients undergoing robot-assisted laparoscopic prostatectomy (RALP).METHODS:
Ninety-two consecutive patients undergoing RALP were divided by age into a middle-aged (45-65 years) and an elderly (> 65 years) group. Anesthesia was standardized. Heart rate, mean arterial pressure, peak inspiratory pressure, lung compliance, minute ventilation, PaO2, PETCO2, PaCO2, and Pa-ETCO2 were measured 10 min after intubation in the supine position without pneumoperitoneum (T0); and 10 (T1), 60 (T2), and 120 (T3) min after pneumoperitoneum in the Trendelenburg position.RESULTS:
Although PETCO2 did not change significantly during surgery, PaCO2 and Pa-ETCO2 increased gradually with time during pneumoperitoneum in the Trendelenburg position, and both parameters showed greater increases in the elderly than in the middle-aged group. Simple linear regression analyses revealed significant correlations between age and Pa-ETCO2 at T0 (P = 0.018), T1 (P = 0.006), T2 (P < 0.001), and T3 (P = 0.001). Linear mixed model analysis showed that Pa-ETCO2 was associated statistically significantly with age and duration of pneumoperitoneum in the Trendelenburg position, but age and duration of pneumoperitoneum in the Trendelenburg position were not associated (P = 0.090).CONCLUSIONS:
The magnitude of Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position increased with age, which could be attributed to age-related respiratory physiological changes.
Texto completo:
Disponível
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pneumoperitônio
/
Prostatectomia
/
Ventilação
/
Carbono
/
Dióxido de Carbono
/
Modelos Lineares
/
Complacência Pulmonar
/
Decúbito Dorsal
/
Decúbito Inclinado com Rebaixamento da Cabeça
/
Pressão Arterial
Limite:
Idoso
/
Humanos
Idioma:
Inglês
Revista:
Korean Journal of Anesthesiology
Ano de publicação:
2012
Tipo de documento:
Artigo