Carbon dioxide elimination during total cardiopulmonary bypass in infants and children

D. R. Larach, K. M. High, J. A. Derr, F. A. Hensley, J. L. Myers, D. R. Williams, M. T. Snider

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Abstract

The authors measured the rate of carbon dioxide elimination (V̇CO2) in 25 pediatric patients (age 2 days to 9 yr) during total cardiopulmonary bypass at average venous blood temperatures ranging from 19.5 to 35.9°C. A multiplexed mass spectrometer was connected to the gas inlet and exhaust ports of the bubble oxygenator, and the gas-phase Fick principle was used to determine V̇CO2. A curvilinear relationship was found between log V̇CO2 and venous blood temperature, and a quadratic regression equation (r2 = 0.74) was fit to the data. Q10 (the ratio of V̇CO2 before and after a 10°C temperature change) was estimated to be 2.7 or 3.0, depending on the analytic method used. Venous blood temperature as a predictor variable explained a greater proportion of the variability of log V̇CO2 than did nasopharyngeal or rectal temperatures. Analysis of covariance revealed that total circulatory arrest during bypass (utilized in 10 patients for 34 ± 4 min, mean ± SEM) affected the relationship of venous blood temperature with log V̇CO2, by increasing the y-intercept (P = .008) but not the slope. These data, with associated 95% prediction intervals, define the expected CO2 elimination rates at various temperatures during standard bypass conditions in our patients. Real-time measurement of V̇CO2 using mass spectrometry can be a useful routine monitor during CPB that may help to assess patient metabolic function, adequacy of perfusion, and oxygenator performance.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalAnesthesiology
Volume69
Issue number2
DOIs
StatePublished - Jan 1 1988

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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    Larach, D. R., High, K. M., Derr, J. A., Hensley, F. A., Myers, J. L., Williams, D. R., & Snider, M. T. (1988). Carbon dioxide elimination during total cardiopulmonary bypass in infants and children. Anesthesiology, 69(2), 185-191. https://doi.org/10.1097/00000542-198808000-00006