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흉강경술을 위한 일측폐환기시 호기말 이산화탄소 분압은 동맥혈 이산화탄소 분압을 적절히 반영하는가?

Other Titles
 Does End-tidal PCO2 Reflect Adequately Arterial PCO2 during One-lung Ventilation for Thoracosco;y? 
 이종석  ;  한정욱  ;  신증수  ;  임광호 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.31(4) : 466-471, 1996-10 
Journal Title
Journal of Korean Society of Anesthesiologist(대한마취과학회지)
Issue Date
Monitoring blood gas ; capnography ; carbon dioxide ; Surgery thracoscopy ; Ventilation one-lung
Maintenance of normal arterial carbon dioxide tension (PaCO2) is not generally a problem if the same tidal volume can be maintained when changing from two-lung(TLV) to one-lung ventilation(OLV). However, there have been a few studies on the use of capnography in monitoring the adequacy of ventilation during one-lung anesthesia. We have therefore studied how closely end-tidal PCO2 (PETCO2) values reflect changes in PaCO2 in patients undergoing thoracoscopic sympathectomy during TLV and after transition to OLV.
We have measured arterial oxygen tension(PaO2), PaCO2, PETCO2, and (PaCO2-PETCO2) in 24 adult, either sex, patients by infra-red spectrometry. They were measured after induction of anesthesia, in supine position(TLVsup), after a lateral decubitus position(TLVlat), at 15 minutes after left OLV(OLVLt), after right OLV(OLVRt), and at 10 minutes in the supine position re-positioned at the end of the operation(TLVrep). Data were analyzed with a one-way analysis of variance with repeated measures followed by multiple comparision. The correlation between PaCO2 and PETCO2 were tested using linear regression.
PaCO2 did not significantly change, whereas PETCO2 significantly decreased at OLVLt, OLVRt compared with TLVsup value (OLVLt, 29.7 mmHg OLVRt, 30.5 mmHg and TLVsup, 33.6 mmHg; P< 0.05). Compared with TLVsup(0.2 mmHg), (PaCO2-PETCO2) significantly increased at OLVLt, OLVRt, TLVrep(3.7 mmHg, 2.3 mmHg, 3.5 mmHg). The correlation between PaCO2 and PETCO2 in these series is consistent. (r>0.65, P<0.0006) CONCLUSIONS: In the patients undergoing thoracoscopic sympathectomy with TLV or OLV in the lateral decubitus position, PETCO2 is a reliable estimate of the PaCO2. However, when the operative time is prolonged the arterial PCO2 may be more reliable than PETCO2.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Shin, Cheung Soo(신증수) ORCID logo https://orcid.org/0000-0001-7829-8458
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
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