Transcutaneous continuous carbon dioxide tension monitoring reduced incidence, degree and duration of hypercapnia during combined regional anaesthesia and monitored anaesthesia care in shoulder surgery patients

Verfasser / Beitragende:
[Werner Baulig, Marija Keselj, Barbara Baulig, Sandra Guzzella, Alain Borgeat, José Aguirre]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/4(2015-08-01), 499-507
Format:
Artikel (online)
ID: 605510237
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024 7 0 |a 10.1007/s10877-014-9627-x  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s10877-014-9627-x 
245 0 0 |a Transcutaneous continuous carbon dioxide tension monitoring reduced incidence, degree and duration of hypercapnia during combined regional anaesthesia and monitored anaesthesia care in shoulder surgery patients  |h [Elektronische Daten]  |c [Werner Baulig, Marija Keselj, Barbara Baulig, Sandra Guzzella, Alain Borgeat, José Aguirre] 
520 3 |a We studied the impact of transcutaneous continuous carbon dioxide tension (PtcCO2) monitoring on ventilation and oxygenation during monitored anaesthesia care (MAC) in patients scheduled for shoulder surgery with continuous interscalene block. 50 patients were randomised either to the intervention (I-group) or the control (C-group) group. In both groups MAC was performed using target controlled infusion of propofol and remifentanil. MAC regimen was adapted to PtcCO2 values in the I-group, whereas the C-group was blinded for these values. Primary outcome was the incidence, degree and duration of hypoventilation stages. In the I-group and the C-group the mean±SD [range] of PtcCO2 and PaCO2 was 5.79±0.84 [4.37] and 5.44±0.59 [2.78] kPa, as well as 6.41±1.17 [6.29] and 6.01±0.96 [7.15] kPa. Periods of PtcCO2/PaCO2>6.5kPa were 21.0±35.7/1.2±4.2min in the I-group and 45.6±40.0/18.6±26.8min in the C-group. Severe hypercapnia (PtcCO2 and/or PaCO2>7.5kPa) was dected in 3/0 patients of the I-group and in 10/3 patients of the C-group. PtcCO2 and PaCO2 showed a strong correlation (r=0.78), but only moderate agreement with a mean bias (LOA) of −0.37 (−1.69; +0.95) kPa showing an overestimation of the PaCO2. Sensitivity and specificity of PtcCO2 to detect changes of PaCO2 was 0.94 and 0.56, respectively. In no patient SpO2 or SaO2 values lower than 90% were measured. Despite a moderate agreement between PaCO2 and PtcCO2 the PtcCO2 monitoring significantly reduced incidence, degree and duration of hypercapnia in shoulder surgery patients with MAC. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a PtcCO2 and SpO2 monitoring  |2 nationallicence 
690 7 |a MAC  |2 nationallicence 
690 7 |a Shoulder surgery  |2 nationallicence 
690 7 |a Ventilation  |2 nationallicence 
700 1 |a Baulig  |D Werner  |u Department of Anaesthesiology and Intensive Care Medicine, Klinik Im Park, Seestrasse 220, 8027, Zurich, Switzerland  |4 aut 
700 1 |a Keselj  |D Marija  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
700 1 |a Baulig  |D Barbara  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
700 1 |a Guzzella  |D Sandra  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
700 1 |a Borgeat  |D Alain  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
700 1 |a Aguirre  |D José  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/4(2015-08-01), 499-507  |x 1387-1307  |q 29:4<499  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-014-9627-x  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10877-014-9627-x  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Baulig  |D Werner  |u Department of Anaesthesiology and Intensive Care Medicine, Klinik Im Park, Seestrasse 220, 8027, Zurich, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Keselj  |D Marija  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Baulig  |D Barbara  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Guzzella  |D Sandra  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Borgeat  |D Alain  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Aguirre  |D José  |u Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/4(2015-08-01), 499-507  |x 1387-1307  |q 29:4<499  |1 2015  |2 29  |o 10877