End-tidal Carbon Dioxide Monitoring in Low Tidal Volume Ventilation

Study Overview
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Brief Summary
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In cases where there is no ventilation-perfusion problem, the end-tidal carbon dioxide (ETCO2) value is closely associated with partial arterial carbon dioxide pressure (PaCO2); therefore, the PaCO2 value can be estimated using ETCO2 measurements in patients without significant cardiopulmonary disorders. The aim of the investigator's study is to evaluate the reliability of pulmonary ventilation monitoring with ETCO2 value and to investigate at what tidal volume values ETCO2 monitoring provides reliable information.

Detailed Description
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The patients were grouped as follows: Group 1, if the tidal volume is 4 ml/kg; Group 2, if TV=6 ml/kg; Group 3, if TV=8 ml/kg; and Group 4, if TV=10 ml/kg. It was determined how many breaths per minute (minute ventilation) would be given with tidal volume x respiratory rate=6 L. The patients were ventilated with the same ventilation parameters for 30 minutes and then arterial blood gas analysis was performed. Arterial blood gas was collected at t1 for group 1, t2 for group 2, t3 for group 3, and t4 for group 4. The ETCO2 value, Peak pressure (Ppeak), Plateau pressure (Pplato), mean airway pressure (Pmean) values were recorded at the time of arterial blood gas collection. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), peak heart rate (PHR) values were evaluated. The patients with a mean arterial pressure of less than 65 mmHg were excluded from the study. Partial arterial oxygen pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2), oxygen saturation (SO2) values were recorded from the arterial blood gas analysis. P (a-ET) CO2 gradient value was calculated. The groups were compared, in each patient, under the same conditions, when the different tidal volume was applied, how the ETCO2 monitorization, PaO2 values and hence the P (a-ET) CO2 gradient changed.

Official Title
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Does End-Tidal Carbon Dioxide Value Show The Adequacy Of Ventilation In Low Tidal Volume Ventilation

Conditions
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Ventilation, End-Tidal Carbon Dioxide

Intervention / Treatment
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* Other: if the ventilation parameter caused desaturation or hypercapnia we will change the parameter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists (ASA) classification 1, 2 risk group Head and neck surgery under general anesthesia lasting more than 120 minutes and who progressed normotensive. Exclusion Criteria: Cardiac disease Pulmonary disease Obese patients

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: sequential
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group 1<br>tidal volüm is 4 ml/kg | Other: if the ventilation parameter caused desaturation or hypercapnia we will change the parameter<br>* we will increased fi02<br>|
| Experimental: Group 2<br>tidal volüm is 6 ml/kg | Other: if the ventilation parameter caused desaturation or hypercapnia we will change the parameter<br>* we will increased fi02<br>|
| Experimental: Group 3<br>tidal volüm is 8 ml/kg | Other: if the ventilation parameter caused desaturation or hypercapnia we will change the parameter<br>* we will increased fi02<br>|
| Experimental: Group 4<br>tidal volüm is 10 ml/kg | Other: if the ventilation parameter caused desaturation or hypercapnia we will change the parameter<br>* we will increased fi02<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| P (a-ET) CO2 gradient | The groups were compared, in each patient, under the same conditions, when the different tidal volume was applied, how the ETCO2 monitorization, PaCO2 values and hence the P (a-ET) CO2 gradient changed. | 120 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Partial arterial oxygen pressure (PaO2) | Partial arterial oxygen pressure (PaO2) were recorded from the arterial blood gas analysis | 120 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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End-Tidal Carbon Dioxide, P(a-ET)CO2 gradient, ETCO2, low tidal volüm, mekanical Ventilation