![]() ![]() In the laparoscopic cholecystectomy patients, a definite plateau in the total exhaled carbon dioxide per minute was observed within 20 minutes from the start of pneumoperitoneum but not in the morbidly obese patients. The total exhaled carbon dioxide per minute increased by the same percentage in both groups (around 20%). The arterial partial pressure of carbon dioxide, end-tidal partial pressure of carbon dioxide, total exhaled carbon dioxide per minute, and arterial blood gas analysis were obtained at 10-minute intervals, along with other cardiorespiratory parameters. The minute ventilation was adjusted to maintain a normal arterial partial pressure of carbon dioxide and normal end-tidal partial pressure of carbon dioxide throughout surgical procedures. The data from 25 patients with a body mass index of 47.7 ± 5.5 kg/m2 undergoing laparoscopic gastric mini-bypass were compared with the data from 25 normal weight patients undergoing laparoscopic cholecystectomy. The setting was a university hospital in Italy. The purpose of the present study was to examine carbon dioxide homeostasis using a metabolic monitor in morbidly obese and normal weight patients during laparoscopic surgical procedures. Am Fam Physician 84: 805–814.Hypercapnia can result from carbon dioxide pneumoperitoneum and adversely affect the postoperative period, particularly in morbidly obese patients. Schroeder R, Garrison JMJR, Johnson MS (2011) Treatment of Adult Obesity with Bariatric Surgery. (2003) Comparison of end-tidal and transcutaneous measures of carbon dioxide during general anaesthesia in severely obese adults. Griffin J, Terry BE, Burton RK, Ray TL, Keller BP, et al. (2006) Transcutaneous monitoring of partial pressure of carbondioxide in the elderly patient: a prospective, clinical comparison with end-tidal monitoring. Anesth Analg 92: 1427–1431.Ĭasati A, Squicciarini G, Malagutti G, Baciarello M, Putzu M, et al. J Clin Monit Comput 15: 23–27.īerkenbosch JW, Lam J, Burd RS, Tobias J (2001) Noninvasive monitoring of carbon dioxide during mechanical ventilation in older children: end-tidal versus transcutaneous techniques. Rohling R, Biro P (1999) Clinical investigation of a new combined pulse oximetry and carbon dioxide tension sensor in adult anaesthesia. In conclusion, transcutaneous carbon dioxide monitoring provides a better estimate of PaCO2 than PetCO2 in severe obese patients undergoing laparoscopic bariatric surgery. The LOA (limits of agreement) of 95% average PaCO2-PetCO2 difference is 10.3 ± 4.6 mmHg (mean ± 1.96 SD), while the LOA of 95% average PaCO2-PTCCO2 difference is 0.9 ± 2.6 mmHg (mean ± 1.96 SD). And the average PaCO2-PetCO2 difference was 10.3 ± 2.3 mmHg (mean ± SD). The average PaCO2-PTCCO2 difference was 0.9 ± 1.3 mmHg (mean ± SD). One patient was eliminated due to the use of vaso-excitor material phenylephrine during anesthesia induction. Bland-Altman method, correlation and regression analysis, as well as exact probability method and two way contingency table were employed for the data analysis. Then the differences between each pair of values (PetCO2-PaCO2) and. Their PaCO2, end-tidal carbon dioxide partial pressure (PetCO2), as well as PTCCO2 values were measured at before pneumoperitoneum and 30 min, 60 min, 120 min after pneumoperitoneum respectively. Twenty-one patients with BMI>35 kg/m(2) were enrolled in our study. ![]() To investigate the correlation and accuracy of transcutaneous carbon dioxide partial pressure (PTCCO2) with regard to arterial carbon dioxide partial pressure (PaCO2) in severe obese patients undergoing laparoscopic bariatric surgery. ![]()
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