신장이식 마취시 수신자에서의 호기말 이산화탄소분압의 변화

Abstract

Background: The increase of arterial to end-tidal PCO difference(Pa-etCO2) is related to the changes of the ventilation/perfusion(V/Q) ratio Pulmonary congestion and depression of left ventricular function has been frequently observed in chronic renal failure patients. The purpose of this study was to determine how closely PetCO2 reflects PaCO2 in recipients during kidney transplantation. Methods: PaCO2 and PetCO2, during operation were measured simultaneously at the period of 20 minutes after induction(Tl), before vascular clamp(T2) and 3 min after clamp release(T4) in 36 kidney recipients. In 3l normal patients, PaCO2, and PetCO2 were measured as a control at Tl. Results". Although there were no differences between normal patients #and kidney recipients in PaCO2, significant lowering of PetCO2 was shown in recipients at Tl. The PaCC#4 at T2 was relatively lower than that of Tl and T4. Whereas Pa-etCO2 was higher in recipients than in normal patients at Tl, PetCO2 and Pa-etCO2 were maintained with the same degree at whole periods. The correlation coefficient between PaCO2 and PetCO2 was 0.73 in norma1 patients, and 0.6, 0.7 and 0.44 at Tl, T2 and T4, respectively. Conclusions: Changes of V/Q ratio during renal transplantation seem to he related to in- creased Pa-etCO2,. Monitoring of PetCO2 could represent the changes of PaCO2 during renal