PaCO2-EtCO2: Arterial to End-Tidal Carbon Dioxide Difference During Pediatric Laparoscopic Surgeries
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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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.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| One sample Laparoscopic surgeries will be performed according to the standard surgical and anesthesia protocols. Pneumo-peritoneum will be achieved using non-heated non-humidified CO2 with the intra-abdominal pressure (IAP) maintained at 10-12mmHg |
Outcome Measures
Primary Outcome Measures
- 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 Outcome Measures
- 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
Eligibility Criteria
Criteria
Inclusion Criteria:
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Children with the following inclusion criteria;
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Weight: 10-30 kg.
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Age: 1-6 years.
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Sex: both males and females.
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ASA physical status: I, II.
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Operation: elective laparoscopic surgeries that last more than 45 min.
Exclusion Criteria:
Patients will be excluded if they have;
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Patients with any perioperative cardiovascular or respiratory event occurred which made the study intervention clinically unacceptable,
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Patients with unsatisfactory preoperative peripheral arterial oxygen saturation,
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Patients with unsatisfactory preoperative hemoglobin level, neurological or psychiatric disease,
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Children with a BMI >95th percentile for age.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Assiut university Pediatric hospital | Assiut | Assiut Governorate | Egypt | 715715 |
Sponsors and Collaborators
- Assiut University
Investigators
- Principal Investigator: Hala Abdelghaffar, MD, professor in Anesthesia department, faculty of medicine, Assiut university, Assiut, Egypt
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 17300081