Noninvasive carbon dioxide monitoring in pediatric patients undergoing laparoscopic surgery: transcutaneous vs. end-tidal techniques

BMC Pediatrics

Research

Weitao Wang¹  Zhifa Zhao¹  Xinggang Ma¹  Guanglin Shang²  Liang Xu²  Xinjie Tian³ 

[1] Department of Anesthesiology, Shenzhen Children’s Hospital, China Medical University, Shenzhen, China;Department of Anesthesiology, Shenzhen Children’s Hospital, Shenzhen, China;Department of Stomatology, Shenzhen Children’s Hospital, China Medical University, Shenzhen, China;

关键词: Transcutaneous carbon dioxide partial pressure;    End-tidal carbon dioxide partial pressure;    Laparoscopic surgery;    Pediatric patients;    General anesthesia;   

DOI  :  10.1186/s12887-023-03836-2

 received in 2022-10-02, accepted in 2023-01-03,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeThe present study aimed to investigate the correlation between transcutaneous carbon dioxide partial pressure (PtcCO2) and arterial carbon dioxide pressure (PaCO2) and the accuracy of PtcCO2 in predicting PaCO2 during laparoscopic surgery in pediatric patients.MethodsChildren aged 2–8 years with American Society of Anesthesiologists (ASA) class I or II who underwent laparoscopic surgery under general anesthesia were selected. After anesthesia induction and tracheal intubation, PtcCO2 was monitored, and radial arterial catheterization was performed for continuous pressure measurement. PaCO2, PtcCO2, and end-tidal carbon dioxide partial pressure (PetCO2) were measured before pneumoperitoneum, and 30, 60, and 90 min after pneumoperitoneum, respectively. The correlation and agreement between PtcCO2 and PaCO2, PetCO2, and PaCO2 were evaluated.ResultsA total of 32 patients were eventually enrolled in this study, resulting in 128 datasets. The linear regression equations were: PtcCO2 = 7.89 + 0.82 × PaCO2 (r2 = 0.70, P < 0.01); PetCO2 = 9.87 + 0.64 × PaCO2 (r2 = 0.69, P < 0.01). The 95% limits of agreement (LOA) of PtcCO2 – PaCO2 average was 0.66 ± 4.92 mmHg, and the 95% LOA of PetCO2 – PaCO2 average was –4.4 ± 4.86 mmHg. A difference of ≤ 5 mmHg was noted between PtcCO2 and PaCO2 in 122/128 samples and between PetCO2 and PaCO2 in 81/128 samples (P < 0.01).ConclusionIn pediatric laparoscopic surgery, a close correlation was established between PtcCO2 and PaCO2. Compared to PetCO2, PtcCO2 can estimate PaCO2 accurately and could be used as an auxiliary monitoring indicator to optimize anesthesia management for laparoscopic surgery in children; however, it is not a substitute for PetCO2.Registration number of Chinese Clinical Trial RegistryChiCTR2100043636.

【 授权许可】

CC BY   
© The Author(s) 2023

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