Document Detail


How often should we perform arterial blood gas analysis during thoracoscopic surgery?
MedLine Citation:
PMID:  18083468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: To continuously measure arterial blood gases (ABGs), to calculate the percentage of anticipated changes over time, and to develop recommendations for sampling frequencies of arterial blood gases in patients undergoing thoracoscopic surgery. DESIGN: Prospective, observational clinical trial. SETTING: University hospital. PATIENTS: 43 consecutive elective patients undergoing thoracoscopic surgery with one-lung ventilation. INTERVENTIONS AND MEASUREMENTS: A Paratrend 7 probe for continuous arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide measurement was introduced through a radial artery cannula in the awake patient before surgery. Data were collected throughout the procedure until patients left the operating room. Afterward, time courses of arterial blood gas values were transformed into frequency space by fast Fourier transform analysis, and the expected deviations in arterial blood gases were calculated over time. MAIN RESULTS: Forty-three consecutive patients undergoing thoracoscopic surgery were included, and arterial blood gas values were measured during a total of 141.5 h. Critical arterial partial pressure of oxygen values <or=60 mmHg were recorded in 16 patients for a total of 4.5 hours. Fourier amplitude spectra showed comparable characteristics of arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide time courses in all patients. It takes only 5, 10, or 20 minutes for the arterial partial pressure of oxygen to change 10%, 20%, or 40%, respectively (95% confidence). CONCLUSIONS: Current standards to monitor arterial blood gases are not sufficient to detect and prevent hypoxemic events during thoracoscopic surgery with one-lung ventilation. Intermittent arterial blood gas analyses must be performed more frequently, up to every 10 minutes, to detect changes of 20% in arterial partial pressure of oxygen.
Authors:
Michael T Ganter; Uwe Schneider; Michel Heinzelmann; Michael Zaugg; Eliana Lucchinetti; Andreas Zollinger; Christoph K Hofer
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  19     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-17     Completed Date:  2008-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  569-75     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Perioperative Care, University of California, San Francisco General Hospital, San Francisco, CA 94110, USA. mt.ganter@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Arteries
Blood Gas Analysis / instrumentation,  methods,  statistics & numerical data
Female
Fourier Analysis
Humans
Male
Middle Aged
Monitoring, Intraoperative / methods*,  statistics & numerical data*
Prospective Studies
Reproducibility of Results
Surgical Procedures, Elective / methods
Thoracoscopy / methods*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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