 |
|
Cardiac Function and Hypercarbia
Jens Peter Rasmussen, MD;
Paul J. Dauchot, MD;
Ralph G. DePalma, MD;
Birgit Sorensen, MD;
Gary Regula, PhD;
Aaron H. Anton, PhD;
Joachim S. Gravenstein, MD
Arch Surg. 1978;113(10):1196-1200.
Abstract
| |
• In 12 patients with heart disease, hypercarbia was induced for carotid endarterectomy. Anesthesia was maintained with nitrous oxide in oxygen and methoxyflurane. In addition to intra-arterial measurements of blood pressure, cardiac output, systolic time intervals (STI), and pressure time indices (PTI) were determined in order to assess cardiovascular responses in these patients. Internal carotid stump blood pressure was measured in five patients before and after induction of hypercarbia. Mild elevation of the Paco2 level affected systolic time intervals but not heart rate and blood pressure. When Paco2 levels reached 56 to 65 torr, systolic but not diastolic blood pressure rose significantly, heart rate and cardiac output increased, while the shortening in the preejection period (PEP), left ventricular ejection lime (LVET), and the decrease in the PEP/LVET ratio signified increased mechanical cardiac activity. Hypercarbia caused intense sympathetic stimulation as demonstrated by twofold to threefold increases in plasma catecholamine levels. Stump blood pressure was elevated. Cardiac oxygen demand was significantly increased, while coronary filling time was shortened, as indicated by the increase in the tension time index and shortening in the diastolic time. This signified a relative myocardial underperfusion. Thus, while hypercarbia to levels of 66 to 70 torr increased internal carotid artery stump pressure, it also caused increased cardiac mechanical activity and concomitant unfavorable balance between myocardial oxygen consumption and supply. The measurement of STI and the computation of PTI provided early detection of alterations in cardiac function.
(Arch Surg 113:1196-1200, 1978)
Author Affiliations
From the departments of anesthesiology (Drs Rasmussen, Dauchot, Sorensen, Anton, and Gravenstein), surgery (Dr DePalma), and biometry (Dr Regula), Case Western Reserve University, School of Medicine, Cleveland.
Footnotes
Accepted for publication June 29, 1978.
Read in part before the 51st Congress of the International Anesthesia Research Society, Hollywood, Fla, March 6-10, 1977.
Reprint requests to Department of Anesthesia, Case Western Reserve University, 2065 Adelbert Rd, Cleveland, OH 44106 (Dr Dauchot).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Carbon dioxide-a complex gas in a complex circulation: Its effects on systemic hemodynamics and oxygen transport, cerebral, and splanchnic circulation in neonates after the Norwood procedure.
Li et al.
J. Thorac. Cardiovasc. Surg. 2008;136:1207-1214.
ABSTRACT
| FULL TEXT
Acute Hypercapnia Improves Indices of Tissue Oxygenation More than Dobutamine in Septic Shock
Wang et al.
Am. J. Respir. Crit. Care Med. 2008;177:178-183.
ABSTRACT
| FULL TEXT
Reversal of Adverse Hemodynamic Effects of Pneumoperitoneum by Pressure Equilibration
Bickel et al.
Arch Surg 2004;139:1320-1325.
ABSTRACT
| FULL TEXT
Preserved Spontaneous Breathing Improves Cardiac Output during Partial Liquid Ventilation
FRANZ et al.
Am. J. Respir. Crit. Care Med. 2001;164:36-42.
ABSTRACT
| FULL TEXT
Arterial PCO2 and Cardiovascular Function During Endoscopic Neck Surgery With Carbon Dioxide Insufflation
Bellantone et al.
Arch Surg 2001;136:822-827.
ABSTRACT
| FULL TEXT
Cardiopulmonary Dysfunction During Minimally Invasive Thoraco-Lumboendoscopic Spine Surgery
Vollmar et al.
Anesth. Analg. 1999;88:1244-1244.
ABSTRACT
| FULL TEXT
Preoperative Pulmonary Function Evaluation for Laparoscopic Cholecystectomy
Wittgen et al.
Arch Surg 1993;128:880-886.
ABSTRACT
Intraperitoneal Carbon Dioxide Insufflation and Cardiopulmonary Functions: Laparoscopic Cholecystectomy in Pigs
Ho et al.
Arch Surg 1992;127:928-933.
ABSTRACT
|
