Korean J Anesthesiol.  2007 Aug;53(2):194-198. 10.4097/kjae.2007.53.2.194.

The Change of Arterial Blood Gas during Endoscopic Saphenous Vein Harvesting for Coronary Artery Bypass Grafting

• Chang JM
• Song CM
• Yon JH
• Lee SS
• Yoo BH
• Kang DU

• KMID: 2243371
• DOI: http://doi.org/10.4097/kjae.2007.53.2.194

Abstract

BACKGROUND: Endoscopic surgical procedure has recently been applied to not only intraabdominal or intrathoracic surgery but also saphenous vein harvesting, because it is less invasive and more cosmetically advantageous. Carbon dioxide insufflation during an endoscopic saphenous vein harvesting may cause an adverse effects on arterial blood gas and hemodynamic variables. This study was conducted to evaluate the safety of carbon dioxide insufflation during endoscopic saphenous vein harvesting.
METHODS
Patients in ASA physical status III or IV, scheduled for an endoscopic saphenous vein harvesting (n=30) were gathered for the evaluation. Until the end of the procedure, controlled mechanical ventilation (tidal volume: 10 ml/kg, respiratory rate: 10 rates/min) and ventilator mode was fixed in this tidal volume and respiratory rate. Arterial blood gas analysis, end-tidal carbon dioxide, blood pressure and heart rate were measured before and at 10, 20, 30, 40 minutes after carbon dioxide insufflation.
RESULTS
Preinsufflation values of PaCO2 (partial pressure of arterial carbon dioxide) and PETCO2 (partial pressure of end-tidal carbon dioxide) were 33.4 +/- 3.6 mmHg and 24.1 +/- 4.1 mmHg, respectively. PaCO2 was significantly increased at 30 and 40 minutes after carbon dioxide insufflation (40.1 +/- 7.4 mmHg and 41.4 +/- 8.6 mmHg). PETCO2 was significantly increased at 20, 30 and 40 minutes after carbon dioxide insufflation(27.6 +/- 5.5 mmHg, 28.9 +/- 7.0 mmHg and 29.6 +/- 7.8 mmHg). But, the magnitude of difference between PaCO2 and PETCO2 was not significantly different.
CONCLUSIONS
During endoscopic saphenous vein harvesting, PaCO2 was significantly increased compared with preinsufflation values. Careful monitoring of PaCO2 is mandatory during the procedure.

Keyword

arterial blood gas; coronary artery bypass grafting; endoscopic surgical procedure; saphenous vein

MeSH Terms

Blood Gas Analysis
Blood Pressure
Carbon
Carbon Dioxide
Coronary Artery Bypass*
Coronary Vessels*
Endoscopy
Heart Rate
Hemodynamics
Humans
Insufflation
Respiration, Artificial
Respiratory Rate
Saphenous Vein*
Tidal Volume
Ventilators, Mechanical
Carbon
Carbon Dioxide