Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial
Abstract Background Most patients undergoing carotid endarterectomy (CEA) are complicated with coronary artery disease and at high risk for cardiovascular events. This study aims to regulate cerebral blood flow by adjusting the level of partial pressure of end-tidal carbon dioxide (PETCO2) to reduce...
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BMC
2025-07-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-03186-9 |
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| author | Pei Wang Chuanyu Liang Yi An Lixia Li Zhongjia Li Xuefei Jia Hongyi Song Tianlong Wang Lei Zhao |
| author_facet | Pei Wang Chuanyu Liang Yi An Lixia Li Zhongjia Li Xuefei Jia Hongyi Song Tianlong Wang Lei Zhao |
| author_sort | Pei Wang |
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| description | Abstract Background Most patients undergoing carotid endarterectomy (CEA) are complicated with coronary artery disease and at high risk for cardiovascular events. This study aims to regulate cerebral blood flow by adjusting the level of partial pressure of end-tidal carbon dioxide (PETCO2) to reduce intraoperative blood pressure fluctuations and improve cardiac function. Methods In this randomized controlled trial, we randomly assigned 44 patients to receive a PETCO2 target of 45-50mmHg during carotid artery occlusion and 30-35mmHg after opening, and 44 patients to receive a PETCO2 target of 35-45mmHg throughout the operation. The primary outcome was E/e’ (the peak velocity of early filling/the early diastolic mitral annular velocity). Secondary outcomes included global longitudinal strain (GLS) of the left ventricular myocardium, dMAP (the change rate of mean arterial pressure relative to the baseline level) and the incidence of postoperative complications. Results Sixty nine patients were finally included, 34 patients in the control group and 35 patients in the intervention group. No significant differences were found between the groups for E/e’ (P = 0.614), GLS (P = 0.231), or the incidence of postoperative complications (P > 0.05). The dMAP of patients during carotid artery occlusion in the intervention group was lower than that in the control group (9.1% ±10.5% vs 14.3% ±9.2%, P < 0.05). Conclusions PETCO2 did not have a significant impact on cardiac function. Trial registration This trial was registered on the Chinese Clinical Trial Registry ( http://www.chictr.org.cn , ChiCTR2100049772; August 9, 2021). |
| format | Article |
| id | doaj-art-26f0e7f2ab494bfeac8747fd7ca82271 |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-26f0e7f2ab494bfeac8747fd7ca822712025-08-20T03:37:41ZengBMCBMC Anesthesiology1471-22532025-07-012511810.1186/s12871-025-03186-9Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trialPei Wang0Chuanyu Liang1Yi An2Lixia Li3Zhongjia Li4Xuefei Jia5Hongyi Song6Tianlong Wang7Lei Zhao8Department of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityDepartment of Anesthesiology, Xuanwu Hospital, Capital Medical UniversityAbstract Background Most patients undergoing carotid endarterectomy (CEA) are complicated with coronary artery disease and at high risk for cardiovascular events. This study aims to regulate cerebral blood flow by adjusting the level of partial pressure of end-tidal carbon dioxide (PETCO2) to reduce intraoperative blood pressure fluctuations and improve cardiac function. Methods In this randomized controlled trial, we randomly assigned 44 patients to receive a PETCO2 target of 45-50mmHg during carotid artery occlusion and 30-35mmHg after opening, and 44 patients to receive a PETCO2 target of 35-45mmHg throughout the operation. The primary outcome was E/e’ (the peak velocity of early filling/the early diastolic mitral annular velocity). Secondary outcomes included global longitudinal strain (GLS) of the left ventricular myocardium, dMAP (the change rate of mean arterial pressure relative to the baseline level) and the incidence of postoperative complications. Results Sixty nine patients were finally included, 34 patients in the control group and 35 patients in the intervention group. No significant differences were found between the groups for E/e’ (P = 0.614), GLS (P = 0.231), or the incidence of postoperative complications (P > 0.05). The dMAP of patients during carotid artery occlusion in the intervention group was lower than that in the control group (9.1% ±10.5% vs 14.3% ±9.2%, P < 0.05). Conclusions PETCO2 did not have a significant impact on cardiac function. Trial registration This trial was registered on the Chinese Clinical Trial Registry ( http://www.chictr.org.cn , ChiCTR2100049772; August 9, 2021).https://doi.org/10.1186/s12871-025-03186-9Carotid endarterectomyE/e’Myocardial strainPartial pressure of end-tidal carbon dioxide |
| spellingShingle | Pei Wang Chuanyu Liang Yi An Lixia Li Zhongjia Li Xuefei Jia Hongyi Song Tianlong Wang Lei Zhao Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial BMC Anesthesiology Carotid endarterectomy E/e’ Myocardial strain Partial pressure of end-tidal carbon dioxide |
| title | Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial |
| title_full | Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial |
| title_fullStr | Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial |
| title_full_unstemmed | Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial |
| title_short | Effects of two different partial pressure of end-tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy: a randomized controlled trial |
| title_sort | effects of two different partial pressure of end tidal carbon dioxide levels on cardiac function in patients undergoing carotid endarterectomy a randomized controlled trial |
| topic | Carotid endarterectomy E/e’ Myocardial strain Partial pressure of end-tidal carbon dioxide |
| url | https://doi.org/10.1186/s12871-025-03186-9 |
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