Effect of mean arterial pressure on arterial to end-tidal CO2 partial pressure difference dur-ing one-lung ventilation
10.3969/j.issn.1673-4254.2014.12.27
- VernacularTitle:平均动脉压对单肺通气患者动脉二氧化碳分压与呼气末二氧化碳分压差的影响
- Author:
Zhaoyan ZENG
1
;
Jing YE
;
Zhenlong ZHAO
;
Zaisheng QIN
Author Information
1. 南方医科大学南方医院麻醉科
- Keywords:
partial pressure of carbon dioxide in endexpiratory gas;
arterial carbon dioxide partial pressure;
one-lung ventilation;
intrapulmonary shunt
- From:
Journal of Southern Medical University
2014;(12):1834-1837
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effect of different mean arterial pressures (MAP) on arterial to end-tidal CO2 partial pressure difference [(Pa-et)CO2] and the intrapulmonary shunt (Qs/Qt) in patients undergoing thoracic surgery during one-lung ventilation (OLV). Methods Forty-two patients undergoing right-sided pulmonary lobectomy were allocated into group A with fluctuation of MAP (at 20 min after OLV) within ± 10%of the baseline (n=22) and group B with lowered MAP by 30%of the baseline (n=20). Arterial and venous blood gas analyses were recorded to calculate [(Pa-et)CO2] and Qs/Qt at 20 min after induction with two-lung ventilation (T1), 20 min after OLV (T2), 30 min after recovery of normal blood pressure (T3), and 20 min after recovery of two-lung ventilation (T4). Results PetCO2 and PaCO2 were well correlated during two-lung ventilation and OLV in group A (P<0.05). In group B, [(Pa-et)CO2] at T2 was significantly higher than that in group A, but PetCO2 was still correlated with PaCO2 (P<0.05). Qs/Qt increased more obviously in group B than in group A in T2 (P<0.05). Bo obvious correlation was found between the [(Pa-et)CO2] and Qs/Qt during OLV. Conclusion PetCO2 reflects the dynamic changes of PaCO2 under normal blood pressure during OLV. In the hypotension period, when [(Pa-et)CO2] increases and the correlation coefficient between PetCO2 and PaCO2 lowers, PetCO2 may not accurately reflect the changes of PaCO2 and blood gas analysis is warranted.
