Basic & clinical pharmacology & toxicology
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Basic Clin. Pharmacol. Toxicol. · Jul 2016
Modelling of the Effect of End-Tidal Carbon Dioxide on Cerebral Oxygen Saturation in Beach Chair Position under General Anaesthesia.
Patients undergoing shoulder surgery in the beach chair position (BCP) under general anaesthesia may be at risk of cerebral desaturation. Increasing end-tidal carbon dioxide (EtCO2 ) is the most convenient and powerful method for the management of cerebral desaturation. The purpose of this study was to investigate the quantitative relationship between EtCO2 and cerebral oxygen saturation (rSO2 ) and to identify the associated influencing factors. ⋯ The presence of diabetes mellitus reduced the reactivity of rSO2 to EtCO2 changes (p < 0.0001). This model-based approach revealed that diabetes mellitus attenuates the response of rSO2 to changes in EtCO2. The management of cerebral desaturation by hypercapnia in patients with diabetes may be less effective than in non-diabetic patients under general anaesthesia with BCP.