Carbon dioxide dynamics during apneic oxygenation

The effects of preceding hypocapnia

Brenda A Gentz, Robert C. Shupak, Shashi B. Bhatt, Curtis Bay

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Study Objective: 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. Design: Randomized, prospective, single crossover study. Setting: Operating room at a teaching hospital. Patients: 19 ASA physical status I, II, and III patients requiring general endotracheal anesthesia and invasive monitoring for elective surgery. Interventions: 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. Measurements and Main Results: 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 also greater in the hypocapneic group prior to apnea. Conclusions: Acute hypocapnia compared with eucapnia prior to apneic oxygenation is associated with a greater rise in PaCO2 in the anesthetized patient. This finding may be due in part to widening of the venoarterial gradient of pCO2.

Original languageEnglish (US)
Pages (from-to)189-194
Number of pages6
JournalJournal of Clinical Anesthesia
Volume10
Issue number3
DOIs
StatePublished - May 1998
Externally publishedYes

Fingerprint

Hypocapnia
Carbon Dioxide
Apnea
Endotracheal Anesthesia
Central Venous Pressure
Partial Pressure
Operating Rooms
Artificial Respiration
Teaching Hospitals
Cross-Over Studies
General Anesthesia
Gases

Keywords

  • Anesthetic techniques: apneic oxygenation
  • Apnea
  • Carbon dioxide
  • Hypocapnia
  • Ventilation: apnea

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Carbon dioxide dynamics during apneic oxygenation : The effects of preceding hypocapnia. / Gentz, Brenda A; Shupak, Robert C.; Bhatt, Shashi B.; Bay, Curtis.

In: Journal of Clinical Anesthesia, Vol. 10, No. 3, 05.1998, p. 189-194.

Research output: Contribution to journalArticle

Gentz, Brenda A ; Shupak, Robert C. ; Bhatt, Shashi B. ; Bay, Curtis. / Carbon dioxide dynamics during apneic oxygenation : The effects of preceding hypocapnia. In: Journal of Clinical Anesthesia. 1998 ; Vol. 10, No. 3. pp. 189-194.
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