Effects of Different Fresh Gas Flows on Carboxyhemoglobin Levels and Postoperative Patient Outcomes in Pediatric Cardiovascular Surgery

Başakşehir Çam & Sakura City Hospital

Status: Enrolling

Conditions: Low Flow Anesthesia; High Flow Anesthesia

Treatments: Other: low and high flow

Study type: Observational

Funder types: Other

Identifiers

NCT06097806

Başakşehir Çam and Sakura

Details and patient eligibility

About

Low flow anesthesia; It is an anesthesia practice in which, after absorbing at least 50% of the exhaled air and carbon dioxide (CO2) using a semi-closed rebreathing system, the unused anesthetic gases are mixed with a certain amount of fresh gas and then completely or partially returned to the patient in the next inspiration. Theoretically, when low flow anesthesia is compared to high or normal flow anesthesia; it is known to have advantages such as using less inhalation agent, preserving mucociliary activity, preventing microatelectasis, preserving the amount of moisture, and reducing temperature loss.

In studies conducted in different fresh gas flows, it has been observed that CO, which is thought to accumulate in the body by rebreathing in a closed circuit, increases as a result of the chemical interaction and dry CO2 absorbent. However, there is no evidence in these studies that low-flow anesthesia increases CO accumulation and alters hemodynamics.

In our clinic, low-flow and high-flow anesthesia technics are both being used. In this study, we aimed to evaluate the effects of high- and low-flow sevoflurane anesthesia applied with a closed system on perioperative carboxyhemoglobin (COHb) levels and hemodynamic system in pediatric cardiovascular surgery cases.

Enrollment: 40 estimated patients

Sex: All

Ages: 2 months to 7 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients between the ages of 2 months and 7 years undergoing elective cardiac surgery
• American Society of Anesthesiology (ASA) score II ve III patients

Exclusion criteria

• Patients undergoing emergency surgery
• Patients who need mechanical ventilation or any respiratory support before the operation
• Patients with left to right shunt
• cyanotic patients
• Patients younger than 2 months and older than 7 years

Trial design

40 participants in 2 patient groups

Low-flow anesthesia group

Description:

In this group, ventilation parameters is adjusted to have fresh gas flow/minute ventilation ratio below 0.5

Treatment:

Other: low and high flow

High-flow anesthesia group

Description:

In this group, ventilation parameters is adjusted to have fresh gas flow/minute ventilation ratio above 1.0

Treatment:

Other: low and high flow