重炭酸ナトリウム投与後の呼気終末二酸化炭素濃度変化の解析

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  • Changes in End-Tidal Carbon Dioxide Tension Following Injection of Sodium Bicarbonate.

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Intravenous administration of sodium bicarbonate (SB) transiently increases end-tidal carbon dioxide tension (PETCO2). We hypothesized that changes in cardiac output (CO) may be estimated according to the changes in PETCO2 after injection of SB.<br>Eight patients were studied. All patients received both general and thoracic epidural anesthesia. Respiration was mechanically controlled. Cardiac output was monitored by continuous thermodilution method. PETCO2 was recorded continuously. Under general anesthesia, a 10ml bolus of 8.4%SB was injected through the antecubital vein (group P). Five minutes later, another 10ml bolus was injected through the subclabian vein (group C). Thirty minutes after epidural injection of mepivacaine, the same procedures were repeated. From the records, the number of breath at which PETCO2 reached maximal value (BNPET-CO2max) and the number of breath (N) following the breathwith PETCO2max to the first breath at which PETCO2 began again to increase were measured.<br>CO decreased in both groups following epidural injection. BNPETCO2max was larger after than before epidural anesthesia in group P; 8 (6-18) and 6 (5-14), median (range). But there was no difference in BNPETCO2max in group C; 4 (3-6) and 4 (3-6). N was larger after than before epidural injection in group C; 7.5 (6-9) and 6.5 (6-7).<br>The changes in CO may be estimated by the changes in PETCO2 immediately after injection of SB.

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