Key result
Transcutaneous CO2 monitoring yields lower values during and after CPB, making arterial sampling preferable.
Why the study?
Does transcutaneous CO2 monitoring accurately reflect arterial and end tidal CO2 levels in adult patients undergoing open heart surgery?
Observational (n=22)
Does transcutaneous CO2 monitoring accurately reflect arterial and end tidal CO2 levels in adult patients undergoing open heart surgery?
Transcutaneous CO2 monitoring is less reliable than arterial blood gas sampling during cardiopulmonary bypass due to suboptimal measurement conditions like hypothermia and hemodilution.
May support non-invasive CO2 monitoring in open heart surgery; leaves open accuracy versus arterial and end-tidal measures in larger trials.
Non Invasive Transcutaneous Carbondioxide Monitoring in Adult Open Heart SurgeryObjective: Follow-up of CO level during open heart surgery is crucial in terms of monitoring and management of the metabolic status. In this prospective observational study,measurement of end tidal CO and arterial CO levels in adult open heart surgery was compared with transcutaneous CO monitoring which is a non-invasive method.Material and Method: The study included 22 ASA II-III patients with an age range of 30-80 years, who will undergo elective open heart surgery. Demographic data, ASA scores, and comorbidities were recorded. Along with routine monitoring of heart surgery, TcCO was placed on deltoid muscle and measurements were obtained pre- and postinduction, and during and following cardiopulmonary bypass (CPB). Results: No difference was observed between pre- and post-induction terms in all three CO values, however a significant decrease was observed during and after cardiopulmonary bypass period in transcutaneous CO , arterial CO and end tidal CO values.Conclusion: During CPB period of heart surgery, conditions, such as hypothermia, hemodilution, and lower arterial blood pressure, may negatively affect the optimal measurement conditions, such as optimal temperature related issues, high capillary perfusions, and calibration issues. The lower TcCO values obtained especially during and following KPB period were thought to be caused by issues related with the device. Because of such challenging issues,, instead of non-invasive CO measurement method, CO mo- nitoring by arterial blood gas samples, which are already obtained during heart surgery anesthesia with invasive artery catheterization, is thought to be a better option.
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Uçar et al. (2013) conducted an observational in Elective open heart surgery (n=22). Transcutaneous CO2 monitoring vs. Arterial CO2 and end tidal CO2 monitoring was evaluated on CO2 levels pre- and post-induction, and during and following cardiopulmonary bypass. Transcutaneous CO2 monitoring yielded significantly decreased values during and after cardiopulmonary bypass, suggesting arterial blood gas sampling remains a better option.
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