title: Association Between Arterial Carbon Dioxide Tension and Outcome in Patients Admitted to the Intensive Care Unit After Coronary Artery Bypass Surgery.
abstract: OBJECTIVE
  The aim of this study was to determine the association between PaCO2and patient outcome in patients admitted to the intensive care unit (ICU) after coronary artery bypass grafting (CABG).
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Single-institutional, university hospital.
  
  
  METHODS
  All patients admitted to the ICU after CABG between January 2009 and December 2012.
  
  
  METHODS
  None.
  
  
  RESULTS
  Based on PaCO2status during the first 24 hours after CABG, 1,011 patients were classified into 4 groups: normocapnia, hypocapnia, hypercapnia, and dual hyper/hypocapnia. The 30-day mortality rate was 0.7% (n = 4) for normocapnia, 1.5% (n = 4) for hypocapnia, 2.2% (n = 3) for hypercapnia, and 7.5% (n = 4) for the dual-exposure group. The extubation times were 13.3±21.7 hours, 15.8±21.37 hours, 21.79±39.70 hours, and 42.29±75.35 hours, respectively. After adjusting for confounding variables, the dual hypocapnia and hypercapnia exposure group was associated with increased 30-day mortality (odds ratio [OR] = 8.08; 95% confidence interval [CI], 1.82-35.86; p = 0.006) and delayed extubation (OR = 2.40; 95% CI, 1.24-4.64; p = 0.010).
  
  
  CONCLUSIONS
  Exposure to both hypocapnia and hypercapnia within 24 hours after CABG was associated independently with increased risk of 30-day mortality and delayed extubation. Exposure to either hypocapnia or hypercapnia alone was not associated with patient outcome.
authors.affiliation: Departments of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea.
authors.forename: Jeong-Hyun
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Eun-Ho
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Departments of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea.
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Jang
authors.affiliation: Departments of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea.
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Jeong
authors.affiliation: Departments of Anesthesiology and Pain Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea. Electronic address: mkanes@gmail.com.
authors.forename: Mi Kyeong
authors.initials: MK
authors.lastname: Kim
mesh_terms: D000368:Aged; D060666:Airway Extubation; D002245:Carbon Dioxide / Q000097:blood*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D016857:Hypocapnia / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010313:Partial Pressure; D011184:Postoperative Period; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D002245:Carbon Dioxide
keywords: arterial carbon dioxide tension; coronary artery bypass grafting; hypercapnia; hypocapnia; normocapnia; outcomes