May 29, 1998

Carbon dioxide dynamics during apneic oxygenation: the effects of preceding hypocapnia

Journal of Clinical Anesthesia
B A GentzC Bay

Abstract

To compare the rate of increase of arterial carbon dioxide tension (PaCO2) during apneic oxygenation preceded by acute respiratory hypocapnia with that during apnea preceded by respiratory eucapnia. Randomized, prospective, single crossover study. Operating room at a teaching hospital. 19 ASA physical status I, II, and III patients requiring general endotracheal anesthesia and invasive monitoring for elective surgery. Two ventilatory states preceding apneic oxygenation were studied in each patient. The first respiratory state was established using controlled mechanical ventilation in the stable, anesthetized patient, followed by a 5-minute period of apneic oxygenation. Arterial and mixed central venous blood gas samples were obtained simultaneously prior to and at 1-minute intervals during apnea. Ventilatory parameters were then changed to establish the second respiratory state. During the subsequent period of apnea, the study was repeated as above. Arterial and mixed central venous partial pressure of carbon dioxide (pCO2) levels were measured. A greater increase in PaCO2 was found during the first minute of apneic oxygenation in the hypocapneic group compared with the eucapneic group. The venoarterial gradient of pCO2 was als...Continue Reading

Mentioned in this Paper

Alveolar Ventilation Function
Cell Respiration
Cross-Over Studies
Elective Surgical Procedures
Anesthesia, Intravenous
Intubation, Intratracheal
Absence of Sensation
Ventilation, Function (Observable Entity)
Respiration
Mechanical Ventilation

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