Evaluation of the Correlation Between End-Tidal Arterial Carbon Dioxide Pressure Based on Mainstream Capnography Technique and Arterial Carbon Dioxide Pressure Based on Arterial Blood Gas Analysis Before and After Cardiopulmonary Bypass Pump in Children With Non-Cyanotic Congenital Heart Defects Publisher



Taghizadeh A¹ ; Faroughi R² ; Nooralishahi B³ Show Affiliations
Source: Medical Journal of Tabriz University of Medical Sciences Published:2022

Abstract

Background. It is still a matter of debate whether the evaluation of end-tidal carbon dioxide (ETCO2) using a capnography device allows the evaluation of non-invasive monitoring of arterial carbon dioxide pressure (PaCO2). The aim of this study was to compare the value of ETCO2 by direct mainstream and PaCO2 based on arterial gas analysis (ABG) before and after cardiopulmonary bypass pump in children with congenital heart defects. Methods. Twenty nine children were enrolled who were candidates for elective cardiac surgery and were admitted to the Children's Medical Center. Before and after cardiopulmonary bypass pump, ETCO2 was evaluated based on mainstream technique and PaCO2 based on arterial gas analysis. Results. The mean difference between ETCO2 and PaCO2 values before cardiopulmonary bypass pump was 5.32± 3.68 mm Hg, which is clinically negligible considering the fact that the difference of less than 5 mm Hg, indicates an acceptable agreement between them. However, the mean difference between the two indices after cardiopulmonary bypass pump was 7.03± 6.85 mm Hg according to which, the difference between the two measured values after cardiopulmonary bypass will be clinically significant. Conclusion. Preoperative ETCO2 evaluation can provide a close prediction of PaCO2 levels, but after pumping, direct arterial sampling should be taken to accurately measure PaCO2 levels in non-cyanotic patients undergoing heart surgery. Practical Implications. Capnography may be used as a reliable predictor of arterial pressure of carbon dioxide in children with non-cyanotic cardiac lesions undergoing corrective cardiac surgery. However, it may not be as reliable after weaning from cardiopulmonary bypass and repeated arterial blood gas analysis may be necessary. © 2022 The Authors.