Abstract
Objective: To verify the hypothesis that the gastric intraluminal Pco2 (Pgco2) changes independently of the change in cardiac output (CO) during and after cardiovascular surgery using cardiopulmonary bypass (CPB), and that the elevation of Pgco2 affects the patients' morbidity. Design: Prospective, noninterventional study. Setting: Medical/surgical intensive care unit and operating theater of a university hospital. Patients: Sixteen adults patients receiving elective cardiovascular surgery using CPB. Interventions: None. Measurements and Main Results: After induction of anesthesia, the patients were fitted with a gastric tube equipped at the tip with a CO2 sensor (ion-selective field effect transistor) that can continuously measure real-time Pgco2, and a pulmonary artery catheter capable of monitoring continuous CO (CCO) and end-tidal CO2. Data from the devices was uploaded to a personal computer every 2 mins until the catheter was pulled off based on clinical judgment (Pgco2 values were blinded to everyone except the investigator). One patient expired as a result of multiple organ failure subsequent to sepsis, and postoperative morbidity assessed by the peak SOFA (sequential organ failure assessment) score (mean ± SD 6.9 ± 3.5; range, 2-13) was correlated with the peak Pgco2 during intensive care unit stay (mean ± SD 74.1 ± 30.7 mm Hg; range, 45-169 mm Hg) (p < .01, by regression analysis). The peak Pgco2 during surgery (mean ± SD 71.1 ± 18.1 mm Hg; range, 44-115 mm Hg) had no correlation with the postoperative morbidity. From analysis of CCO before, during, and after returning from the above 60 mm Hg of Pgco2, Pgco2 changed independently of CCO. Conclusions: Pgco2 changed independently of CCO, and its postoperative elevation was related to morbidity, even in the group of patients with a good outcome. Continuous monitoring of Pgco2 is useful for the detection of morbidity and can be expected to help elucidate the pathophysiology of change of Pgco2.
| Original language | English |
|---|---|
| Pages (from-to) | 44-51 |
| Number of pages | 8 |
| Journal | Critical Care Medicine |
| Volume | 30 |
| Issue number | 1 |
| Publication status | Published - 2002 |
| Externally published | Yes |
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Keywords
- Cardiac output
- Cardiopulmonary bypass
- Cardiovascular surgery
- End-tidal CO
- Gastric intraluminal Pco
- Morbidity
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Continuous monitoring of gastric intraluminal carbon dioxide pressure, cardiac output, and end-tidal carbon dioxide pressure in the perioperative period in patients receiving cardiovascular surgery using cardiopulmonary bypass. / Imai, Takasuke; Sekiguchi, Tetsushi; Nagai, Yuko; Morimoto, Takushi; Nosaka, Toshihisa; Mitaka, Chieko; Makita, Koushi; Sunamori, Makoto.
In: Critical Care Medicine, Vol. 30, No. 1, 2002, p. 44-51.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Continuous monitoring of gastric intraluminal carbon dioxide pressure, cardiac output, and end-tidal carbon dioxide pressure in the perioperative period in patients receiving cardiovascular surgery using cardiopulmonary bypass
AU - Imai, Takasuke
AU - Sekiguchi, Tetsushi
AU - Nagai, Yuko
AU - Morimoto, Takushi
AU - Nosaka, Toshihisa
AU - Mitaka, Chieko
AU - Makita, Koushi
AU - Sunamori, Makoto
PY - 2002
Y1 - 2002
N2 - Objective: To verify the hypothesis that the gastric intraluminal Pco2 (Pgco2) changes independently of the change in cardiac output (CO) during and after cardiovascular surgery using cardiopulmonary bypass (CPB), and that the elevation of Pgco2 affects the patients' morbidity. Design: Prospective, noninterventional study. Setting: Medical/surgical intensive care unit and operating theater of a university hospital. Patients: Sixteen adults patients receiving elective cardiovascular surgery using CPB. Interventions: None. Measurements and Main Results: After induction of anesthesia, the patients were fitted with a gastric tube equipped at the tip with a CO2 sensor (ion-selective field effect transistor) that can continuously measure real-time Pgco2, and a pulmonary artery catheter capable of monitoring continuous CO (CCO) and end-tidal CO2. Data from the devices was uploaded to a personal computer every 2 mins until the catheter was pulled off based on clinical judgment (Pgco2 values were blinded to everyone except the investigator). One patient expired as a result of multiple organ failure subsequent to sepsis, and postoperative morbidity assessed by the peak SOFA (sequential organ failure assessment) score (mean ± SD 6.9 ± 3.5; range, 2-13) was correlated with the peak Pgco2 during intensive care unit stay (mean ± SD 74.1 ± 30.7 mm Hg; range, 45-169 mm Hg) (p < .01, by regression analysis). The peak Pgco2 during surgery (mean ± SD 71.1 ± 18.1 mm Hg; range, 44-115 mm Hg) had no correlation with the postoperative morbidity. From analysis of CCO before, during, and after returning from the above 60 mm Hg of Pgco2, Pgco2 changed independently of CCO. Conclusions: Pgco2 changed independently of CCO, and its postoperative elevation was related to morbidity, even in the group of patients with a good outcome. Continuous monitoring of Pgco2 is useful for the detection of morbidity and can be expected to help elucidate the pathophysiology of change of Pgco2.
AB - Objective: To verify the hypothesis that the gastric intraluminal Pco2 (Pgco2) changes independently of the change in cardiac output (CO) during and after cardiovascular surgery using cardiopulmonary bypass (CPB), and that the elevation of Pgco2 affects the patients' morbidity. Design: Prospective, noninterventional study. Setting: Medical/surgical intensive care unit and operating theater of a university hospital. Patients: Sixteen adults patients receiving elective cardiovascular surgery using CPB. Interventions: None. Measurements and Main Results: After induction of anesthesia, the patients were fitted with a gastric tube equipped at the tip with a CO2 sensor (ion-selective field effect transistor) that can continuously measure real-time Pgco2, and a pulmonary artery catheter capable of monitoring continuous CO (CCO) and end-tidal CO2. Data from the devices was uploaded to a personal computer every 2 mins until the catheter was pulled off based on clinical judgment (Pgco2 values were blinded to everyone except the investigator). One patient expired as a result of multiple organ failure subsequent to sepsis, and postoperative morbidity assessed by the peak SOFA (sequential organ failure assessment) score (mean ± SD 6.9 ± 3.5; range, 2-13) was correlated with the peak Pgco2 during intensive care unit stay (mean ± SD 74.1 ± 30.7 mm Hg; range, 45-169 mm Hg) (p < .01, by regression analysis). The peak Pgco2 during surgery (mean ± SD 71.1 ± 18.1 mm Hg; range, 44-115 mm Hg) had no correlation with the postoperative morbidity. From analysis of CCO before, during, and after returning from the above 60 mm Hg of Pgco2, Pgco2 changed independently of CCO. Conclusions: Pgco2 changed independently of CCO, and its postoperative elevation was related to morbidity, even in the group of patients with a good outcome. Continuous monitoring of Pgco2 is useful for the detection of morbidity and can be expected to help elucidate the pathophysiology of change of Pgco2.
KW - Cardiac output
KW - Cardiopulmonary bypass
KW - Cardiovascular surgery
KW - End-tidal CO
KW - Gastric intraluminal Pco
KW - Morbidity
UR - http://www.scopus.com/inward/record.url?scp=0036152692&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036152692&partnerID=8YFLogxK
M3 - Article
C2 - 11902286
AN - SCOPUS:0036152692
VL - 30
SP - 44
EP - 51
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 1
ER -