Inadvertent Hyperventilation During Intraoperative Anesthetic Care in the Pediatric Population
| Autor: | Thomas Taghon, Joseph D. Tobias, Andrew Rozmiarek |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty Alkalosis business.industry medicine.medical_treatment Incidence (epidemiology) Management Science and Operations Research Critical Care and Intensive Care Medicine Critical Care Nursing medicine.disease Surgery Anesthesia Cohort Anesthetic Hyperventilation medicine Arterial blood Respiratory system medicine.symptom business medicine.drug |
| Zdroj: | ICU Director. 3:172-175 |
| ISSN: | 1944-4524 1944-4516 |
| DOI: | 10.1177/1944451612449182 |
| Popis: | Background. Recent clinical data suggest that inadvertent intraoperative hyperventilation may have long-lasting deleterious effects during the postoperative period with the potential for exaggerating the respiratory depressant effect of opioids. The current study identified the incidence of inadvertent hyperventilation during intraoperative anesthetic care in a cohort of pediatric patients. Methods. A retrospective review of the electronic medical record system was performed on patients undergoing posterior spinal fusion. These patients were chosen as arterial blood gas (ABG) analysis is routinely performed for such cases. ABG data were analyzed for the occurrence of hyperventilation, defined as alkalosis (pH ≥ 7.45) concurrent with hypocarbia (PaCo2 ≤ 35 mm Hg). Results. The study cohort included 166 patients who ranged in age from 22 months to 21 years. There were a total of 452 ABG samples obtained. Hyperventilation with the combination of alkalosis and hypocarbia was noted in 40 of the 452 (9%) ABG samples. An episode of hyperventilation was noted at some point in 30 of 166 patients (18%). When comparing hyperventilated with nonhyperventilated patients, only the mode of ventilation showed a statistically significant relationship with hyperventilation being more common with pressure- versus volume-limited ventilation. Conclusion. Inadvertent intraoperative hyperventilation is common-place in the pediatric population. In the adult population, it is now being appreciated that such practices may have deleterious effects on physiologic function that last into the postoperative period. |
| Databáze: | OpenAIRE |
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