Effect of end-tidal carbon dioxide partial pressure on cerebral oxygen saturation and hemodynamics during anesthesia induction in children undergoing ventricular septal defect repair
Wang Xiaonan
Han Ding
Yang Yanwei
Li Gang
Ouyang Chuan
Abstract：Objective To investigate the effect of end-tidal carbon dioxide partial pressure(PETCO2) on cerebral oxygen saturation(rScO2) and hemodynamics during anesthesia induction in children undergoing ventricular septal defect(VSD) repair.Methods A total of 44 children undergoing VSD repair from April to May 2017 in Beijing Anzhen Hospital,Capital Medical University were divided into ≥6 months group(n =24) and ＜ 6 months group(n =20).Radial artery pressure was monitored by the MostCare hemodynamic device and right frontal rScO2 was monitored by the Fore-Sight device during general anesthesia.PETCO2 was maintained at 30(P1),35 (P2),40(P3),45(P4) mmHg;rScO2,heart rate(HR),systolic pressure,dicrotic pressure,diastolic pressure,stroke volume index,cardiac index(CI),systemic vascular resistance index(SVRI) and pulse pressure variation(PPV)were recorded at P1,P2,P3,P4.Results rScO2 significantly increased with PETCO2 in both groups[rScO2 of ≥6 months group at P1,P2,P3,P4 was (65±3)％,(69±3)％,(74±3)％,(77±4)％;rScO2 of ＜6 months group at P1,P2,P3,P4 was (71 ±6)％,(74±6)％,(78 ±5)％,(80±4)％] (P＜0.001).Variation amplitude of rScO2 in ＜ 6 months group was more significant than that in ≥6 months group(P =0.011).Systolic pressure,CI and PPV decreased with the increase of PETCO2 in ≥ 6 months group;SVRI decreased with the increase of PETCO2 in ＜ 6 months group;HR decreased first then increased in both groups(all P ＜ 0.05).Systolic pressure in ≥6 months group was significantly higher than that in ＜ 6 months group(P =0.024);there was no statistical differences of other parameters between groups (P ＞ 0.05).Conclusions Variations of rScO2 and hemodynamics during anesthesia induction are tolerable in children undergoing VSD repair.Due to limited cerebral vascular function reserve,the cerebral oxygenation in young children is more affected by the fluctuation of PETCO2.
Keywords：Ventricular septal defectAge of onsetCarbon dioxideCerebral oxygen saturationHemodynamics
Publication Date：2018-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 495-498 )