Decrease in spectral entropy by low tidal volume ventilation-associated severe hypercapnia: a case report.
10.4097/kjae.2017.70.2.213
- Author:
Junggun ANN
1
;
Sung Mee JUNG
;
Sang Jin PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, Yeungnam University School of Medicine, Daegu, Korea. applejsm@gmail.com
- Publication Type:Case Report
- Keywords:
Electroencephalography;
Entropy;
Hypercapnia;
Hypoventilation
- MeSH:
Acid-Base Equilibrium;
Acidosis, Respiratory;
Arterial Pressure;
Blood Gas Analysis;
Carbon Dioxide;
Electroencephalography;
Entropy*;
Humans;
Hypercapnia*;
Hyperventilation;
Hypoventilation;
Lung;
Oxygen;
Propofol;
Thoracic Surgery;
Tidal Volume*;
Ventilation
- From:Korean Journal of Anesthesiology
2017;70(2):213-216
- CountryRepublic of Korea
- Language:English
-
Abstract:
Severe hypercapnia can be predicted by a decrease in cerebral electrical activity. The authors describe a sudden decrease in spectral entropy due to severe hypercapnia-induced respiratory acidosis in a patient with chronic pulmonary obstructive disease during lung resection. After two and a half hours of low tidal volume ventilation in the lateral position, the state entropy suddenly dropped from 45 to 7, without any changes in the effect-site concentration of propofol, end-tidal carbon dioxide (CO₂) tension, oxygen saturation, or arterial pressure. However, arterial blood gas analysis showed severe respiratory acidosis (pH 7.01, PaCO₂ 115 mmHg and PaO₂ 246 mmHg with FIO₂ of 0.5). Immediate hyperventilation improved the state entropy and acid-base balance. Electroencephalography-based spectral entropy can detect severe hypercapnia in chronic pulmonary obstructive disease patients with a large arterial to end-tidal CO2 difference due to prolonged hypoventilation during thoracic surgery.
