title: Carbon dioxide production during cardiopulmonary bypass: pathophysiology, measure and clinical relevance.
abstract: Carbon dioxide production during cardiopulmonary bypass derives from both the aerobic metabolism and the buffering of lactic acid produced by tissues under anaerobic conditions. Therefore, carbon dioxide removal monitoring is an important measure of the adequacy of perfusion and oxygen delivery. However, routine monitoring of carbon dioxide removal is not widely applied. The present article reviews the main physiological and pathophysiological sources of carbon dioxide, the available techniques to assess carbon dioxide production and removal and the clinically relevant applications of carbon dioxide-related variables as markers of the adequacy of perfusion during cardiopulmonary bypass.
authors.affiliation: 1 Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ranucci
authors.affiliation: 1 Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carboni
authors.affiliation: 1 Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Cotza
authors.affiliation: 2 Heart Centre, University Hospital Ghent, Ghent, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: de Somer
mesh_terms: D000818:Animals; D002245:Carbon Dioxide / Q000032:analysis* / Q000097:blood / Q000302:isolation & purification / Q000378:metabolism*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006801:Humans; D019344:Lactic Acid / Q000032:analysis / Q000097:blood / Q000378:metabolism; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000032:analysis / Q000097:blood / Q000378:metabolism; D010477:Perfusion / Q000379:methods
chemical_list: D002245:Carbon Dioxide; D019344:Lactic Acid; D010100:Oxygen
keywords: blood lactates; capnography; carbon dioxide; cardiopulmonary bypass; oxygen delivery