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Materials and Methods: There were enrolled 257 patients, without significant heart and respiratory problems, operated in sitting position (F:M = 108:149, age 48.24 ± 16.14). After standard induction, mechanical ventilation was started (VT = 6 ml/kg, RR = 12/min) and after 10 ml/kg of saline given in 15 min, the patients were postured in sitting position. Standard ECG, IBP, EtCO2, SpO2, VT, and RR were monitored, as well as CVP in 138 patients. Data are presented as mean ± SD, T-test and correlation (r) are used for statistical evaluation and p < 0.05 is considered as statistically significant.
Results: Decrease of EtCO2 was observed instantly after positioning the patients in sitting position. Drop of EtCO2 was 4.36 ± 2.56 mmHg (p < 0.01) and it paralleled the decrease of MAP (12.25 ± 8.13 mmHg (p < 0.05), increase of HR 11.69 ± 8.48 bpm (p < 0.01) and CVP drop of 5.12 ± 1.04 mmHg (p < 0.001). Such changes were present for 5-8 minutes and usually were corrected with administration of 5-10 ml/kg saline. 49 patients (19.6%) developed pronounced haemodynamic instability (MAP < 20% of baseline) and showed significantly larger decrease of EtCO2 (7.54 ± 3.42 mmHg, p < 0.05) compared with others. Haemodynamic in this group of patients was corrected with ephedrine in perfusion. Correlation between EtCO2 changes and haemodynamic instability shows strong relationship (r = 0.87).
Conclusion: Changes of capnography are significant in sitting position. EtCO2 changes parallels the haemodynamic and are an early warning of its change due to positioning of patient.
