Efficacy and Safety of Percutaneous Blood Gas Monitoring in Perioperative Management of Lung Surgery

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K18218
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55040:Respiratory surgery-related
• Research Institution: Hiroshima University
• Principal Investigator: Fujiwara Makoto 広島大学, 原爆放射線医科学研究所, 専門研究員 (60780442)
• Project Period (FY): 2019-04-01 – 2021-03-31
• Keywords: 経皮血液ガスモニタ / 肺切除術 / 周術期管理 / 術後合併症

Outline of Final Research Achievements

Preoperative blood gas analysis, postoperative blood gas analysis, and intraoperative blood gas analysis were tested 121 times. The correlation coefficient between CO2 and PaCO2 of the transcutaneous blood gas monitoring was r2 = 0.923 (n = 121), and that between EtCO2 and PaCO2 was r2 = 0.650 (n = 65). The correlation coefficient between EtCO2 and PaCO2 was r2 = 0.650 (n = 65). All patients were managed with one-lung ventilation during the operation, but despite the decrease in ventilation, most patients did not show significant CO2 accumulation, and CO2 tended to accumulate most during spontaneous breathing immediately after extubation. In addition, there was a case of gradual postoperative CO2 accumulation, which was diagnosed as CO2 narcosis, and the patient was transferred from a general hospital bed to ICU management, demonstrating the usefulness of 24-hour monitoring with transcutaneous blood gas monitoring.

Free Research Field

胸部外科学

Academic Significance and Societal Importance of the Research Achievements

本研究は呼吸器外科領域における、経皮血液ガスモニタリングの有用性を検証した研究である。肺切除術は、術前後の呼吸機能が変化する点、ならびに術中の分離肺換気による片肺換気が患者に与える影響を正しく把握することが肝要である。しかし、毎度の血管穿刺をおこない血液ガス分析を行う侵襲は高く、病棟でも簡易に測定する手法の開発が必要である。今回、我々は経皮血液ガス分析の有効性を示し、術中のEtCO2よりも有用な指標であり、モニタリングの精度が高いこと。また、周術期の呼吸不全に対しても時系列データを把握することで早急な治療が行われたことを示した。これによりより良い周術期管理の一助となると思われる。