Changes in end-tidal CO2 level following tourniquet deflation during orthopedic surgery
Changes in end-tidal CO2 level following tourniquet deflation during orthopedic surgery
复制标题
骨科手术期间止血带放气后潮气末二氧化碳水平的变化
作者：
T. Akata;M. Tominaga;Mihaya Sagiyama;T. Taniyama;S. Inaba;Shosuke Takahashi;J. Yoshitake
我们研究了上肢和/或下肢骨科手术期间自主呼吸和通气控制的患者在止血带放气后呼气末二氧化碳 (ETCO2) 的变化和全身反应。在大多数患者中，观察到 ETCO2、心率和 PaCO2 增加，以及血压和 pH 值降低。每个自主呼吸患者的呼吸频率在 ETCO2 达到最大值之前就开始增加。动脉血气分析表明，ETCO2 的增加与PaCO2 的增加密切相关。我们的研究得出了关于 ETCO2 变化的新信息：1）尽管自主呼吸组和通气控制组 ETCO2 的增加存在显着差异，但 ETCO2 水平达到峰值的时间（峰值时间）几乎恒定，且前者的峰值时间短于后者； 2）提示当止血带时间和止血带面积相同时，自主呼吸患者的 ETCO2 增加幅度小于通气控制患者。我们的数据表明，在某些情况下，ETCO2（或 PaCO2）的增加可能会很大且持续时间较长。因此，我们建议持续监测 ETCO2 并在止血带放气时适当过度通气，以尽量减少酸中毒的任何不利影响。
We studied the changes in end-tidal CO2 (ETCO2) and systemic responses after tourniquet deflation in spontaneously breathing and ventilation-controlled patients during orthopedic surgery of both the upper and/or the lower extremities. In most patients, increases in ETCO2, heart rate, and PaCO2, as well as decreases in blood pressure and pH were observed. In every spontaneously breathing patient, the respiratory rate began to increase before the ETCO2 reached a maximum. Arterial blood gas analysis suggested that the increase in ETCO2 closely reflected the increase in PaCO2. Our study yielded new information on the ETCO2 changes as follows: 1) the time for ETCO2 level to reach a peak (peak time) was almost constant despite the considerable differences in the increases in ETCO2 both in spontaneous breathing and ventilation-controlled groups and the peak time in the former group was shorter than that in the latter group; and 2) it was suggested that the increase in ETCO2 in the spontaneously breathing patients was smaller than that in ventilation-controlled patients when both patients were subjected to the same conditions on tourniquet time and tourniqueted area. Our data showed that the increase in ETCO2 (or PaCO2) can be large and prolonged in some situations. Thus, we recommend continuous ETCO2 monitoring and the proper hyperventilation at tourniquet deflation in order to minimize any adverse effects of acidosis.
运动对接受 Ia 型抗心律失常药物治疗的多形性室性心动过速患者 QT 间期的反常影响。
影响因子：
37.8
作者：
Kadish,AH;Weisman,HF;Veltri,EP;Epstein,AE;Slepian,MJ;Levine,JH
通讯作者：
Levine,JH