Effects of Different Fresh Gas Flows on Carboxyhemoglobin Levels and Postoperative Patient Outcomes in Pediatric Cardiovascular Surgery
Study Details
Study Description
Brief Summary
Low flow anesthesia; It is an anesthesia practice in which, after absorbing at least 50% of the exhaled air and carbon dioxide (CO2) using a semi-closed rebreathing system, the unused anesthetic gases are mixed with a certain amount of fresh gas and then completely or partially returned to the patient in the next inspiration. Theoretically, when low flow anesthesia is compared to high or normal flow anesthesia; it is known to have advantages such as using less inhalation agent, preserving mucociliary activity, preventing microatelectasis, preserving the amount of moisture, and reducing temperature loss.
In studies conducted in different fresh gas flows, it has been observed that CO, which is thought to accumulate in the body by rebreathing in a closed circuit, increases as a result of the chemical interaction and dry CO2 absorbent. However, there is no evidence in these studies that low-flow anesthesia increases CO accumulation and alters hemodynamics.
In our clinic, low-flow and high-flow anesthesia technics are both being used. In this study, we aimed to evaluate the effects of high- and low-flow sevoflurane anesthesia applied with a closed system on perioperative carboxyhemoglobin (COHb) levels and hemodynamic system in pediatric cardiovascular surgery cases.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Low-flow anesthesia group In this group, ventilation parameters is adjusted to have fresh gas flow/minute ventilation ratio below 0.5 |
Other: low and high flow
low and high flow anesthesia are both being used. The effects of different gas flows will be evaluated.
|
| High-flow anesthesia group In this group, ventilation parameters is adjusted to have fresh gas flow/minute ventilation ratio above 1.0 |
Other: low and high flow
low and high flow anesthesia are both being used. The effects of different gas flows will be evaluated.
|
Outcome Measures
Primary Outcome Measures
- COHb levels [at the 30th minute of the surgery, at the beginning of cardiopulmonary bypass, at the time of chest closure, at the time of intensive care unit admission]
COHb values will be measured in arterial blood gas samples at different fresh gas flow levels.
Secondary Outcome Measures
- extubation time [at the time that patient is extubated up to 24 hours]
the time of extubation
- body temperature [at the 30th minute of the surgery, at the beginning of cardiopulmonary bypass, at the time of chest closure, at the time of intensive care unit admission]
body temperature
- bleeding [24 hours]
Total amount of bleeding during the first 24 hours
- vasoactive inotrope score (VIS) [postoperative first hour]
VIS at the end of the operation
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients between the ages of 2 months and 7 years undergoing elective cardiac surgery
-
American Society of Anesthesiology (ASA) score II ve III patients
Exclusion Criteria:
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Patients undergoing emergency surgery
-
Patients who need mechanical ventilation or any respiratory support before the operation
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Patients with left to right shunt
-
cyanotic patients
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Patients younger than 2 months and older than 7 years
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Basaksehir Cam and Sakura City Hospital | Istanbul | Turkey |
Sponsors and Collaborators
- Basaksehir Cam & Sakura Şehir Hospital
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Başakşehir Çam and Sakura