Arterial to End-Tidal Carbon Dioxide Difference During Pediatric Laparoscopic Surgeries (PaCO2-EtCO2)

Assiut University

Status: Completed

Conditions: Intraoperative Ventilation

Study type: Observational

Funder types: Other

Identifiers

NCT03361657

17300081

Details and patient eligibility

About

Studying the arterial to end-tidal carbon dioxide difference in children undergoing laparoscopic surgeries under different intra-abdominal pressures is of extreme importance. This is because both hyper and hypocarbia are detrimental in this vulnerable age group.

Full description

Capnography provides a non-invasive estimate of arterial CO2 levels and allows clinicians to modify mechanical ventilation settings in order to maintain normocapnia. Normally, a positive gap between arterial CO2 and ETCO2 of approximately 0.5 kPa is assumed in a healthy patient and ventilation settings are adjusted accordingly. However, the correlation between PaCO2 and PetCO2 during laparoscopic surgery is inconsistent mainly due to inter- and intra-individual variability. Discrepancies between arterial carbon dioxide and End-tidal carbon dioxide measures have been demonstrated in ventilated children with cyanotic congenital heart disease , infants with respiratory failure and during visceral and urological laparoscopic surgery. Moreover, as the increase in PaCO2 is directly proportional to the level of intra-abdominal pressure (IAP) used, variations in the arterial to end-tidal carbon dioxide difference can be also expected with different levels of IAP used.

Enrollment: 29 patients

Sex: All

Ages: 1 to 6 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children with the following inclusion criteria;
• Weight: 10-30 kg.
• Age: 1-6 years.
• Sex: both males and females.
• ASA physical status: I, II.
• Operation: elective laparoscopic surgeries that last more than 45 min.

Exclusion criteria

Patients will be excluded if they have;

• Patients with any perioperative cardiovascular or respiratory event occurred which made the study intervention clinically unacceptable,
• Patients with unsatisfactory preoperative peripheral arterial oxygen saturation,
• Patients with unsatisfactory preoperative hemoglobin level, neurological or psychiatric disease,
• Children with a BMI >95th percentile for age.

Trial design

29 participants in 1 patient group

One sample

Description:

Laparoscopic surgeries will be performed according to the standard surgical and anesthesia protocols. Pneumo-peritoneum will be achieved using non-heated non-humidified CO2 with the intra-abdominal pressure (IAP) maintained at 10-12mmHg