None listed
Conditions
Brief summary
A retrospective observational study evaluating the association of hyperkalaemia in normocarbic and hypercarbic patients who have undergone laparoscopic abdominal surgery at Austin health. This observational QI project will be conducted by the department of Anaesthesia at Austin Health. There is very limited research exploring the association between hypercarbia and potassium levels in an adult human population. It is known that hypercarbia detected in blood gas sampling correlates to processes that result in serum acidaemia, and it has also been theorized that an acidosis caused by hypercarbia may be related to changes in plasma potassium levels. As part of routine standard care at Austin Health, blood gas sampling is conducted intra-operatively and analysed in theatre using a blood gas analysis machine. Results of these studies are recorded in Austin Health’s electronic medical record system (CERNER). This retrospective observational study aims to determine the relationship between hypercarbia and hyperkalaemia as there is the potential to developing life-threatening cardiac arrhythmias and cardiac arrest due to electrolyte imbalances. This study aims to achieve the following objectives: 1) Determination of the relationship between hypercarbia and hyperkalaemia 2) Determine the magnitude of hyperkalaemic change from baseline 3) Detail the subsequent potential clinical impact of hyperkalaemia in patients intraoperatively, and post-operatively 4) Identify any patient factors that contribute to changes in serum potassium that may allow future identification of patient populations at risk of hyperkalaemia. 5) Contribute to the limited human data on hyperkalaemia and acidosis. As this is a quality improvement project, data will be collected retrospectively, and there will be no change to anaesthesia or surgical care in any way. All data collected has already been collected by normal hospital anaesthesia and surgical processes. No new data will be collected. There will be no clinical or patient contact involved at any time point for this project.
Interventions
There is no participant involvement as this is a retrospective review of the patient medical records. Patients undergoing major laparoscopic surgery who develop hypercapnia during surgery will be retrospectively evaluated. From this retrospective cohort we will use the hospital electronic medical record system (CERNER) to identify patients with intraoperative hypercapnia, which will be defined as a partial pressure of arterial carbon dioxide (PaCO2) greater than 45 mmHg.
Sponsors
Austin Health
Eligibility
Sex/Gender
All
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
We will include: 1. adult patients greater than 40 years 2. undergoing major laparoscopic surgical procedure, and 3. require mechanical ventilation in the operating suite, and 4. require an arterial line as part of standard haemodynamic monitoring Major surgery is defined as surgery greater than 2 hours duration and a hospital stay of at least 1 postoperative night
Exclusion criteria
1. Any non laparoscopic abdominal surgery 2. The patient has planned thoracic surgery 3. The patient has planned cardiac surgery 4. The patient is pregnant 5. The patient has planned intracranial neurosurgery
Outcome results
None listed