RT Journal Article
SR Electronic
T1 The value of capnogram parameters to detect adverse lung mechanical changes following cardiopulmonary bypass
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2252
DO 10.1183/13993003.congress-2016.PA2252
VO 48
IS suppl 60
A1 József Tolnai
A1 Ferenc Peták
A1 Gergely Fodor
A1 Ádám L. Balogh
A1 Zsófia Csorba
A1 Barna Babik
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2252.abstract
AB Although capnography is standard part of respiratory monitoring in mechanically ventilated patients, its diagnostic value has not been established. We aimed to reveal how changes in lung mechanics are reflected in the alterations in the capnogram curves after lung function deteriorations to cardiopulmonary bypass (CPB). Anaesthetized, mechanically ventilated patients (n=101) were studied under open-chest condition before and 5 min after CPB. Changes in airway resistance (dRaw), tissue damping (dG) and elastance (dH) were measured by forced oscillations. Time and volumetric capnography were performed to assess changes in the parameters reflecting the normalized phase II (dSnIIT, dSnIIV) and III slopes (dSnIIIT, dSnIIIV), and the dead-space indices according to Fowler (dVDF), Bohr (dVDB) and Enghoff (dVDE). dRaw correlated best with dSnIIT, whereas dG displayed similar relationships with the alterations in the various capnographic indices after CPB. The changes in CPB-induced lung tissue stiffness revealed statistically significant correlations with phase-III slope parameters (dSnIIIT, dSnIIIV). Complex adverse changes in the airway and lung tissue mechanical properties appear in different capnogram indices: (i) the bronchoconstriction is reflected the best in SnII and VDF (ii) the SnIII is affected by changes in both airway and tissue mechanics.dSnIIITdSnIITdSnIIIVdSnIIVdVDFdVDBdVDEdRaw0.54*-0.70*0.55*-0.39*-0.12-0.140.10dG0.40*-0.27*0.41*-0.33*-0.27*-0.200.002dH0.28*-0.050.33*-0.150.09-0.030.04*p<0.05 (Pearson correlation)Correlation coefficients between CPB induced changes in the lung mechanical and capnogram parametersGrant: TÁMOP 4.2.4.A/2-11-1-2012-0001, OTKA K115253.