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

Takasuke Imai, Tetsushi Sekiguchi, Yuko Nagai, Takushi Morimoto, Toshihisa Nosaka, Chieko Mitaka, Koushi Makita, Makoto Sunamori

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageEnglish
Pages (from-to)44-51
Number of pages8
JournalCritical Care Medicine
Volume30
Issue number1
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Perioperative Period
Cardiopulmonary Bypass
Carbon Dioxide
Cardiac Output
Stomach
Carbon Monoxide
Pressure
Morbidity
Intensive Care Units
Catheters
Organ Dysfunction Scores
Multiple Organ Failure
Microcomputers
Critical Care
Pulmonary Artery
Sepsis
Anesthesia
Regression Analysis
Research Personnel
Prospective Studies

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 journalArticle

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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.",
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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.

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KW - End-tidal CO

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KW - Morbidity

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