[Effects of age, body weight, and ventilatory pattern on the difference between arterial and end-tidal PCO2].
OBJECTIVE
To evaluate the effects of physiological ventilatory patterns on P(a-ET)CO2 gradient and on the alveolar dead space production during controlled mechanical ventilation.


METHODS
Prospective and experimental comparison among three different ventilatory settings in three different groups of subjects.


METHODS
General surgery's operating-theatre in university hospital.


METHODS
Twenty-eight patients subdivided randomly in 3 groups differing for ventilatory setting. I group: constant tidal volume (VC = 8 ml.kg-1) and 3 different respiratory frequencies (f = 10, 12 and 14 breaths.min-1); II group: constant ventilation (112 ml.kg-1) but VC and f modified in three different ways; III group: inspiratory volume was set to give an end-tidal PCO2 (PETCO2) of about 35 mmHg. The cases were subdivided, on the basis of P(a-ET)CO2 distribution, in three groups: group with values larger than mean plus 1 standard deviation, group with values between +/- 1 standard deviation and group with values lower than mean minus 1 standard deviation. Moreover in two homogeneous groups for age.


METHODS
General surgery but not important because measures were performed before surgical manoeuvres.


RESULTS
Anthropometrical data (age and body weight), PaCO2, PETCO2, heart rate, invasive arterial pressure, ventilatory parameters and airway pressure were collected for every subject and ventilatory setting; arterial to end-tidal difference P(a-ET)CO2 and P(a-ET)CO2.PaCO2(-1) were calculated during data analysis. The P(a-ETFCO2 and P(a-ET)CO2.PaCO2(-1) values were not significantly different among the three different ventilatory patterns both in the first and in the second group. P(a-ET)CO2 values were significantly correlated with age, body weight and airway pressure. These parameters were correlated significantly also with P(a-ET)CO2.PaCO2(-1) values.


CONCLUSIONS
Ventilatory setting, used in a normal physiological range, don't affect P(a-ET)CO2 difference during mechanical ventilation. Age, body weight and airway pressure of the patient must be considered to obtain a correct value of PaCO2 by the measure of PETCO2.
Colò
F
F
Cattedra di Anestesia e Rianimazione, Università degli Studi di Udine.
Girardis
M
M
Pasqualucci
A
A
Da Broi
U
U
Pasetto
A
A
D000328:Adult; D000375:Aging; D001835:Body Weight; D002245:Carbon Dioxide / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D015656:Respiratory Mechanics / Q000502:physiology*
D002245:Carbon Dioxide
Effetti di età, peso corporeo e pattern ventilatorio sulla differenza tra PCO2 arteriosa e fine espirazione.