Perioperative Rule And Clinical Significance Of PetCO2 In Coronary Artery Bypass Grafting Under Cardiopulmonary Bypass

[Objective]To study the changes of the partial pressure of carbon dioxide(PetCO2)in the peri-operative period of coronary artery bypass grafting(CPB)under extracorporeal circulation(CABG),and to explain its clinical significance.[Methods]taking 42 patients with coronary artery bypass grafting under cardiopulmonary bypass selected from September 2017 to March 2018 at Fuwai Hospital of Cardiovascular Diseases in Yunnan Province as research objects,we divided the patients into two groups according to the time of cardiopulmonary bypass:group A:extracorporeal circulation transition time<120 min;group B:extracorporeal circulation transition time>120 min.Preoperative(T0),before extracorporeal circulation(T1),and stop-circulation(T3),1 h after stoppage(T3)?4 h(T4)?12 h(T5)?24h(T6)and 48h(T7),we draw to monitor changes in PetCO2 values using a mainstream method.;the related indexes were detected,and the changing rules were observed and analyzed.[Results]1.There was no statistical significance on the age,gender,oxygenation index,APACHE ? score,and New York Heart Association class between the two groups in preoperative and postoperative;2.The values of BNP and LVEF in the two groups were statistically significant(P<0.05)at the 1 day after operation,but the trend of CO and CI was larger,but there was no statistical difference(P>0.05);3.In the two groups,the PH value decreased in T2-T6,and began to rise to T7.Through the two independent sample t-test,there was no significant difference in the corresponding time point between the two groups(P>0.05);4.The PetCO2 values of the two groups began to decrease at T3 hours,T6 decreased to the lowest level,and then gradually increased,but T7 was still at a low level.There was no significant difference in the time of PaCO2 between the two groups except To,Ti and T2,and the difference was statistically significant at other time points(P<0.05);5.After two independent sample t-test,there was no significant difference in Pa-etCO2 corresponding time points between the two groups(P>0.05).[Conclusion]1.PetCO2 can be used as an important non-invasive monitoring during preoperative period of coronary artery bypass grafting under cardiopulmonary bypass;2.The level of PetCO2 can reflect the degree of cardiopulmonary function in patients undergoing coronary artery bypass grafting under cardiopulmonary bypass;3.Pa-etCO2 does not change with the prolongation of cardiopulmonary bypass.PetCO2 can be used as a real-time indicator of PaCO2.