Nous avons émis l’hypothèse que des valeurs de ΔCO 2 plus élevées seraient associées à l’apparition d’un résultat composite de réintubation, de ventilation mécanique postopératoire ou de mortalité à 30 jours chez les patients bénéficiant d’une chirurgie non cardiaque. Compte tenu de sa relation avec la ventilation et la perfusion, la ΔCO 2 pourrait fournir des informations pronostiques et guider les décisions cliniques. La différence entre la pression partielle artérielle et télé-expiratoire en dioxyde de carbone (ΔCO 2) est une mesure de l’espace mort alvéolaire couramment évaluée en période peropératoire.

Future studies are needed to determine if ΔCO 2 can be used to guide patient management and improve patient outcomes. In this patient population, increased intraoperative ΔCO 2 was associated with an increased odds of the composite outcome of postoperative mechanical ventilation, re-intubation, or 30-day mortality that was independent of its relationship with pre-existing pulmonary disease. After adjusting for baseline subject characteristics, every 5-mm Hg increase in the ΔCO 2 was associated with a nearly 20% increased odds of the composite outcome (odds ratio, 1.20 95% confidence interval, 1.12 to 1.28 P < 0.001). Univariable analysis showed an association between higher mean (standard deviation ) intraoperative ΔCO 2 values and the composite outcome (6.1 vs 5.7 mm Hg P = 0.002). ResultsĪ total of 19,425 patients were included in the final study population. Logistic regression was used for multivariable analysis of the relationship of ΔCO 2 with the composite outcome. Student’s t test and Chi-squared test were used for univariable analysis. The composite outcome, identified from electronic health records, was re-intubation, postoperative mechanical ventilation, or 30-day mortality. We conducted a historical cohort study of adult patients undergoing non-cardiac surgery with an arterial line at a single tertiary care medical centre. We hypothesized that higher ΔCO 2 values are associated with occurrence of a composite outcome of re-intubation, postoperative mechanical ventilation, or 30-day mortality in patients undergoing non-cardiac surgery. Given its relationship to ventilation and perfusion, ΔCO 2 may provide prognostic information and guide clinical decisions. The difference between arterial and end-tidal partial pressure of carbon dioxide (ΔCO 2) is a measure of alveolar dead space, commonly evaluated intraoperatively.

Alveolar dead space and end tidal co2