[Evaluation of tissue perfusion by simultaneous monitoring of aortic flow rate and capnography].
Ten patients under general anaesthesia were subjected to non-invasive haemodynamic monitoring, together with arterial gasometry and capnography. When enflurane was administered for maintenance anaesthesia, a 33 percent fall in aortic flow rate was observed (P less than 0.01), together with prolongation of the pre-ejection period and left ventricular pre-ejection/ejection ratio, an increase of central venous pressure and total vascular systemic resistances. The end-expiratory CO2 (Pet CO2) was reduced by 13 percent (P less than 0.05). There was no significant variation in arteriolo-alveolar CO2 difference (P(a-A)CO2). Under dobutamine (mean dose: 3.4 +/- 0.5 micrograms/kg/min), the haemodynamic parameters returned to their initial values. Pet CO2 rose above its initial level (+ 12 percent; P less than 0.05), but P(a-A)CO2 was not significantly modified. The variations of Pet CO2 were parallel with those of aortic flow rate. It is concluded that the changes in Pet CO2 observed during haemodynamic modifications could be used as markers for qualitative evaluation of tissue perfusion.
Brunel
D
D
Département d'Anesthésie-Réanimation, Clinique mutualiste E.-André, Lyon.
Muchada
R
R
D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects*; D002496:Central Venous Pressure / Q000187:drug effects*; D004280:Dobutamine / Q000494:pharmacology* / Q000627:therapeutic use; D004737:Enflurane / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006991:Hypnosis, Anesthetic / Q000379:methods; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000601:surgery; D013318:Stroke Volume / Q000187:drug effects*
D004280:Dobutamine; D004737:Enflurane
Evaluation de la perfusion tissulaire par surveillance simultanée du débit aortique et de la capnographie.