Optimizing the intraoperative management of carbon dioxide concentration

Current Opinion in Anaesthesiology

Volumn 19, Issue 1, 2006, Pages 19-25

  Akça, Ozan ^a,b  

^a University of Louisville School of Medicine   (United States)

^b NONE   (United States)

Author keywords

Carbon dioxide; Cardiac output; Hypercapnia; Hypocapnia; Ischemia; Oxygen; Perfusion; Reperfusion; Tissue oxygenation

Indexed keywords

BARBITURIC ACID DERIVATIVE; CARBON DIOXIDE; DESFLURANE; ISOFLURANE; KETAMINE; NITROUS OXIDE; OPIATE; PROPOFOL; SEVOFLURANE;

ANESTHESIA; ARTERIAL CARBON DIOXIDE TENSION; BLEEDING; BRAIN BLOOD FLOW; BRAIN BLOOD VESSEL; BRAIN HEMORRHAGE; BRAIN TUMOR; BREATHING; END TIDAL CARBON DIOXIDE TENSION; GENERAL ANESTHESIA; HEART OUTPUT; HUMAN; HYPERVENTILATION; HYPOCAPNIA; HYPOTHESIS; INTRACRANIAL PRESSURE; INTRAOPERATIVE PERIOD; MEAN ARTERIAL PRESSURE; MEDICAL SOCIETY; NONHUMAN; ORGAN TRANSPLANTATION; PERFUSION PRESSURE; PERIOPERATIVE PERIOD; PEROPERATIVE CARE; PHYSIOLOGY; PRACTICE GUIDELINE; PRIORITY JOURNAL; REPERFUSION INJURY; RESUSCITATION; REVIEW; SURVIVAL; TISSUE GRAFT; TISSUE OXYGENATION; TISSUE PERFUSION; TRAUMATIC BRAIN INJURY; TUMOR GROWTH; VASCULAR SURGERY; WAKEFULNESS;

ANESTHESIA, GENERAL; ANESTHETICS, INHALATION; ANESTHETICS, INTRAVENOUS; CARBON DIOXIDE; CARDIAC OUTPUT; CARDIOPULMONARY RESUSCITATION; CEREBROVASCULAR CIRCULATION; HUMANS; HYPERVENTILATION; INTRAOPERATIVE CARE; OXYGEN CONSUMPTION; REGIONAL BLOOD FLOW;

EID: 33144489014     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.aco.0000192776.32398.5c     Document Type: Review

References (63)

1. Greif R, Akça O, Horn E-P, et al. Supplemental perioperative oxygen to reduce the incidence of surgical wound infection. N Engl J Med 2000; 342:161-167.
2. Gosain A, Rabin J, Reymond JP, et al. Tissue oxygen tension and other indicators of blood loss or organ perfusion during graded hemorrhage. Surgery 1991; 109:523-532.
3. Shoemaker W, Appel P, Kram H. Oxygen transport measurements to evaluate tissue perfusion and titrate therapy: dobutamine and dopamine effects. Crit Care Med 1991; 19:672-688.
4. Ikeda T, Tayefeh F, Sessler DI, et al. Local radiant heating increases subcutaneous oxygen tension. Am J Surg 1998; 175:33-37.
5. Plattner O, Akça O, Herbst F, et al. The influence of two surgical bandage systems on wound tissue oxygen tension. Arch Surg 2000; 135:818-822.
6. Akça O, Melischek M, Scheck T, et al. Postoperative pain and subcutaneous oxygen tension. Lancet 1999; 354:41-42.
7. 2) in anaesthesia and perioperative medicine. Br J Anaesth 2004; 92:464-468. A very good editorial on tissue oxygenation in the perioperative period.
8. Akça O, Doufas A, Morioka N, et al. Hypercapnia improves tissue oxygenation. Anesthesiology 2002; 97:801-806.
9. 2 on global hemodynamics and gastric perfusion. Crit Care Med 2000; 28:360-365.
10. Akca O, Liem E, Suleman M, et al. Effect of intra-operative end-tidal carbon dioxide partial pressure on tissue oxygenation. Anaesthesia 2003; 58:536-542.
11. Andersen M, Mouritzen C. Effect of acute respiratory and metabolic acidosis on cardiac output and peripheral resistance. Ann Surg 1966; 63:161-168.
12. Manley J, E.S. Nash C, Woodbury R. Cardiovascular responses to severe hypercapnia of short duration. Am J Physiol 1964; 207:634-640.
13. Boniface K, Brown J. Effect of carbon dioxide excess on contractile force of heart, in situ. Am J Physiol 1953; 172:752-756.
14. Monroe R, French G, Whittenberger J. Effect of hypocapnia and hypercapnia on myocardial contractility. Am J Physiol 1960; 199:1121-1124.
15. Wolley K, Lewis T, Wood L. Acute respiratory acidosis decreases left ventricular contractility but increases cardiac output in dogs. Circ Res 1990; 100:102-106.
16. Cullen D, Eger E, Gregory G. The cardiovascular effects of carbon dioxide in man, conscious and during cyclopropane anesthesia. Anesthesiology 1969; 31:407-413.
17. Ng M, Levy M, Zieske H. Effects of changes of pH and of carbon dioxide tension on left ventricular performance. Am J Physiol 1967; 213:115-120.
18. 2 inotropy response curve. Anesthesiology 1972; 37:268-276.
19. 2 on cardiac performance in conscious dogs. J Appl Physiol 1967; 22:147-152.
20. Blackburn JP, Conway CM, Leigh JM, et al. Myocardial carbon dioxide response curves. Br J Anaesth 1970; 42:559.
21. Gelb A. Control of the cerebral circulation - What clinician needs to know. In: American Society of Anesthesiologists - Anuual Meeting Refresher Course Lectures; 2004 October 23-27, 2004; Las Vegas, Nevada. 2004. pp. 377. Outstanding refresher course lecture notes from an expert about clinical effects of anesthetic agents on cerebrovascular reactivity.
22. Duong T, Iadecola C, Kim S-G. Effect of Hyperoxia, Hypercapnia, and Hypoxia on Cerebral Interstitial Oxygen Tension and Cerebral Blood Flow. Magn Reson Med 2001; 45:61-70.
23. Weckesser M, Posse S, Olthoff U, et al. Functional imaging of the visual cortex with bold-contrast MRI: hyperventilation decreases signal response. Magn Reson Med 1999; 41:213-216.
24. Huttunen J, Tolvanen H, Heinonen E, et al. Effects of voluntary hyperventilation on cortical sensory responses: electroencephalographic and magnetoencephalographic studies. Exp Brain Res 1999; 125:248-254.
25. Safar P, Xiao F, Radovsky A, et al. Improved cerebral resuscitation from cardiac arrest in dogs with mild hypothermia plus blood flow promotion. Stroke 1996; 27:105-113.
26. Gleason C, Short B, Jones MJ. Cerebral blood flow and metabolism during and after prolonged hypocapnia in newborn lambs. J Pediatr 1989; 115:309-314.
27. ATP ion channel link in the inhibition of hypercapnic dilation of pial artrioles by 7-nitroindazole and tetrodotoxin. Eur J Pharmacol 2001; 417:203-215.
28. Wei E, Kontos H. Blockage of ATP-sensitive potassium channels in cerebral arterioles inhibits vasoconstriction from hypocapnoc alkalosis in cats. Stroke 1999; 30:851-854.
29. Vannucci R, Brucklacher R, Vannucci S. Effect of carbon dioxide on cerebral metabolism during hypoxia-ischemia in the immature rat. Pediatr Res 1997; 42:24-29.
30. Akca O, Payne R, Sessler D, et al. Hypercapnic acidosis -but neither metabolic acidosis nor hypercapnia without acidosis- preconditions brain slices to ischemia-reperfusion injury. In: American Society of Anesthesiologists; 2004. Las Vegas, Nevada: Liipincott Williams & Wilkins; 2004.
31. Manley G, Hemphill J, Morabito D, et al. Cerebral oxygenation during hemorrhagic shock: perils of hyperventilation and therapeutic potential of hypoventilation. J Trauma 2000; 48:1025-1033.
32. Alberti E, Hoyer S, Hamer J, et al. The effect of carbon dioxide on cerebral blood flow and cerebral metabolism in dogs. Br J Anaesth 1975; 47:941-947.
33. 2, and bicarbonate on pial vessels. Stroke 1977; 8:358-360.
34. Leon JE, Bissonnette B. Cerebrovascular responses to carbon dioxide in children anaesthetized with halothane and isoflurane. Can J Anaesth 1991; 38:817-825.
35. Matta BF, Heath KJ, Tipping K, et al. Direct cerebral vasodilatory effects of sevoflurane and isoflurane. Anesthesiology 1999; 91:677-680.
36. Nishiyama T, Matsukawa T, Yokoyama T, et al. Cerebrovascular carbon dioxide reactivity during general anesthesia: a comparison between sevoflurane and isoflurane. Anesth Analg 1999; 89:1437-1441.
37. Strebel S, Kaufmann M, Baggi M, et al. Cerebrovascular carbon dioxide reactivity during exposure to equipotent isoflurane and isoflurane in nitrous oxide anaesthesia. Br J Anaesth 1993; 71:272-276.
38. Young WL, Prohovnik I, Correll JW, et al. A comparison of cerebral blood flow reactivity to CO2 during halothane versus isoflurane anesthesia for carotid endarterectomy. Anesth Analg 1991; 73:416-421.
39. Wilson-Smith E, Karsli C, Luginbuehl I, et al. Effect of nitrous oxide on cerebrovascular reactivity to carbon dioxide in children during sevoflurane anaesthesia. Br J Anaesth 2003; 91:190-195.
40. Cottrell J. Brain protection in neurosurgery. In: American Society of Anesthesiologists - Anuual Meeting Refresher Course Lectures; 2004 October 23-27, 2004; Las Vegas, Nevada. 2004. pp. 145. Excellent refresher course lecture notes from an expert about perioperative brain protection with excellent physiology.
41. Karsli C, Wilson-Smith E, Luginbuehl I, et al. The effect of nitrous oxide on cerebrovascular reactivity to carbon dioxide in children during propofol anesthesia. Anesth Analg 2003; 97:694-698.
42. Matta BF, Mayberg TS, Lam AM. Direct cerebrovasodilatory effects of halothane, isoflurane, and desflurane during propofol-induced isoelectric electroencephalogram in humans. Anesthesiology 1995; 83:980-985 (discussion 27A).
43. Karsli C, Luginbuehl I, Bissonnette B. The cerebrovascular response to hypocapnia in children receiving propofol. Anesth Analg 2004; 99:1049-1052. An excellent original article on cerebrovascular effects of carbon dioxide under propofol anesthesia in children. This article also includes some notes about the comparison of the effects of sevoflurane and propofol.
44. Karsli C, Luginbuehl I, Farrar M, et al. Cerebrovascular carbon dioxide reactivity in children anaesthetized with propofol. Paediatr Anaesth 2003; 13:26-31.
45. Kaisti KK, Langsjo JW, Aalto S, et al. Effects of sevoflurane, propofol, and adjunct nitrous oxide on regional cerebral blood flow, oxygen consumption, and blood volume in humans. Anesthesiology 2003; 99:603-613.
46. Mirzai H, Tekin I, Tarhan S, et al. Effect of propofol and clonidine on cerebral blood flow velocity and carbon dioxide reactivity in the middle cerebral artery. J Neurosurg Anesthesiol 2004; 16:1-5.
47. Nagase K, Iida H, Ohata H, et al. Ketamine, not propofol, attenuates cerebrovascular response to carbon dioxide in humans with isoflurane anesthesia. J Clin Anesth 2001; 13:551-555.
48. Laffey JG, Engelberts D, Kavanagh BP. Injurious effects of hypocapnic alkalosis in the isolated lung. Am J Respir Crit Care Med 2000; 162:399-405.
49. Amato M, Barbas C, Medeiros D, et al. Effect of protective-ventilation stragetgy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998; 338:347-354.
50. Hickling KG, Walsh J, Henderson S, et al. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med 1994; 22:1568-1578.
51. Laffey J, Kavanagh B. Carbon dioxide and the critically ill - too little of a good thing? Lancet 1999; 354:1283-1286.
52. Laffey J, Kavanagh B. Biological effects of hypercapnia. Intensive Care Med 2000; 26:133-138.
53. Shibata K, Cregg N, Engelberts D, et al. Hypercapnic acidosis may attenuate acute lung injury by inhibition of endogenous xanthine oxidase. Am J Respir Crit Care Med 1998; 158:1578-1584.
54. Laffey JG, Tanaka M, Engelberts D, et al. Therapeutic hypercapnia reduces pulmonary and systemic injury following in vivo lung reperfusion. Am J Respir Crit Care Med 2000; 162:2287-2294.
55. Noble W, Kay J, Fisher J. The effect of PCO2 on hypoxic pulmonary vasoconstriction. Can Anaesth Soc J 1981; 28:422-430.
56. Boix JH, Marin J, Enrique E, et al. Modifications of tissular oxygenation and systemic hemodynamics after the correction of hypocapnia induced by mechanical ventilation. Rev Esp Fisiol 1994; 50:19-26.
57. Richardson D, Kontos H, Raper A, et al. Systemic circulatory responses to hypocapnia in man. Am J Physiol 1972; 223:1308-1312.
58. Nomura F, Aoki M, Forbess J, et al. Effects of hypercarbic acidotic reperfusion on recovery of myocardial function after cardiopleghic ischemia in neonatal lambs. Circulation 1994; 90:321-327.
59. Ali S, Hahn H, Jacobsohn E, et al. Therapeutic effects of carbon dioxide administration following cardiac surgery. In: American Society of Anesthesiologists (ASA) Annual Meeting; 2003 October 11-15, 2003. San Francisco, CA: Lippincott Williams & Wilkins; 2003. pp. A431.
60. Hickling K, Joyce C. Permissive hypercapnia in ARDS and its effects on tissue oxygenation. Acta Anaesthesiol Scand 1995; 107:201-208.
61. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science, Part I: Introduction. Circulation 2000; 102 (8 Suppl.):l1-I11.
62. Aufderheide T, Sigurdsson G, Pirrallo R, et al. Hyperventilation-induced hypotension during cardiopulmonary resuscitation. Circulation 2004; 109:1960-1965. Outstanding original studies on the detrimental effects of hyperventilation during CPR.
63. Aufderheide T, Lurie K. Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation. Crit Care Med 2004; 32 (9 Suppl):S345-S351. An excellent review article on the detrimental effects of hyperventilation during CPR.