Intraoperative Ventilation
Conditions
Brief summary
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.
Detailed 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.
Interventions
None listed
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Years to 6 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between the Arterial to end-tidal carbon dioxide | Intraoperative | The arterial CO2 will be analysed from the blood gas and the endtidal carbon dioxide will be recorded from the capnography tracing. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PaCO2-ETCO2 Difference | Intraoperative | The arterial CO2 will be analysed from the blood gas and the endtidal carbon dioxide will be recorded from capnography. |
| Heart rate | Intraoperative | The heart rate will be continuously monitored, intraoperatively |
| The noninvasive systolic and diastolic arterial blood pressure | intraoperative | The non invasive systolic and diastolic arterial blood pressure will be recorded at fixed intervals |
Countries
Egypt
Outcome results
None listed