Kenya Yarimizu, Yu Onodera, Hiroto Suzuki, Masaki Nakane, Kaneyuki Kawamae
{"title":"全身麻醉诱导过程中氧气供需平衡的变化：使用雷马唑仑进行的探索性研究。","authors":"Kenya Yarimizu, Yu Onodera, Hiroto Suzuki, Masaki Nakane, Kaneyuki Kawamae","doi":"10.1007/s00540-024-03362-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to evaluate the changes in oxygen supply-demand balance during induction of general anesthesia using an indirect calorimeter capable of measuring oxygen consumption (VO<sub>2</sub>) and carbon dioxide production (VCO<sub>2</sub>).</p><p><strong>Methods: </strong>This study included patients scheduled for surgery in whom remimazolam was administered as a general anesthetic. VO<sub>2</sub> and VCO<sub>2</sub> were measured at different intervals: upon awakening (T1), 15 min after tracheal intubation (T2), and 1 h after T2 (T3). Oxygen delivery (DO<sub>2</sub>) was calculated simultaneously with these measurements. VO<sub>2</sub> was ascertained using an indirect calorimeter and further calculated using vital signs, among other factors. DO<sub>2</sub> was derived from cardiac output and arterial blood gas analysis performed with an arterial pressure-based cardiac output measurement system.</p><p><strong>Results: </strong>VO<sub>2</sub>, VCO<sub>2</sub>, and DO<sub>2</sub> decreased significantly from T1 to T2 and T3 [VO<sub>2</sub>/body surface area (BSA) (ml/min/m<sup>2</sup>): T1, 130 (122-146); T2, 107 (83-139); T3, 97 (93-121); p = 0.011], [VCO<sub>2</sub>/BSA (ml/min/m<sup>2</sup>): T1, 115 (105-129); T2, 90 (71-107); T3, 81 (69-101); p = 0.011], [DO<sub>2</sub>/BSA (ml/min/m<sup>2</sup>): T1, 467 (395-582); T2, 347 (286-392); T3, 382 (238-414); p = 0.0020]. Among the study subjects, a subset exhibited minimal reduction in VCO<sub>2</sub>. Although the respiratory frequency was titrated on the basis of end-tidal CO<sub>2</sub> levels, there was no significant difference between the groups.</p><p><strong>Conclusion: </strong>General anesthetic induction with remimazolam decreased VO<sub>2</sub>, VCO<sub>2</sub>, and DO<sub>2</sub>.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Changes in oxygen supply-demand balance during induction of general anesthesia: an exploratory study using remimazolam.\",\"authors\":\"Kenya Yarimizu, Yu Onodera, Hiroto Suzuki, Masaki Nakane, Kaneyuki Kawamae\",\"doi\":\"10.1007/s00540-024-03362-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>This study was performed to evaluate the changes in oxygen supply-demand balance during induction of general anesthesia using an indirect calorimeter capable of measuring oxygen consumption (VO<sub>2</sub>) and carbon dioxide production (VCO<sub>2</sub>).</p><p><strong>Methods: </strong>This study included patients scheduled for surgery in whom remimazolam was administered as a general anesthetic. VO<sub>2</sub> and VCO<sub>2</sub> were measured at different intervals: upon awakening (T1), 15 min after tracheal intubation (T2), and 1 h after T2 (T3). Oxygen delivery (DO<sub>2</sub>) was calculated simultaneously with these measurements. VO<sub>2</sub> was ascertained using an indirect calorimeter and further calculated using vital signs, among other factors. DO<sub>2</sub> was derived from cardiac output and arterial blood gas analysis performed with an arterial pressure-based cardiac output measurement system.</p><p><strong>Results: </strong>VO<sub>2</sub>, VCO<sub>2</sub>, and DO<sub>2</sub> decreased significantly from T1 to T2 and T3 [VO<sub>2</sub>/body surface area (BSA) (ml/min/m<sup>2</sup>): T1, 130 (122-146); T2, 107 (83-139); T3, 97 (93-121); p = 0.011], [VCO<sub>2</sub>/BSA (ml/min/m<sup>2</sup>): T1, 115 (105-129); T2, 90 (71-107); T3, 81 (69-101); p = 0.011], [DO<sub>2</sub>/BSA (ml/min/m<sup>2</sup>): T1, 467 (395-582); T2, 347 (286-392); T3, 382 (238-414); p = 0.0020]. Among the study subjects, a subset exhibited minimal reduction in VCO<sub>2</sub>. Although the respiratory frequency was titrated on the basis of end-tidal CO<sub>2</sub> levels, there was no significant difference between the groups.</p><p><strong>Conclusion: </strong>General anesthetic induction with remimazolam decreased VO<sub>2</sub>, VCO<sub>2</sub>, and DO<sub>2</sub>.</p>\",\"PeriodicalId\":14997,\"journal\":{\"name\":\"Journal of Anesthesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-06-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00540-024-03362-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00540-024-03362-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Changes in oxygen supply-demand balance during induction of general anesthesia: an exploratory study using remimazolam.
Purpose: This study was performed to evaluate the changes in oxygen supply-demand balance during induction of general anesthesia using an indirect calorimeter capable of measuring oxygen consumption (VO2) and carbon dioxide production (VCO2).
Methods: This study included patients scheduled for surgery in whom remimazolam was administered as a general anesthetic. VO2 and VCO2 were measured at different intervals: upon awakening (T1), 15 min after tracheal intubation (T2), and 1 h after T2 (T3). Oxygen delivery (DO2) was calculated simultaneously with these measurements. VO2 was ascertained using an indirect calorimeter and further calculated using vital signs, among other factors. DO2 was derived from cardiac output and arterial blood gas analysis performed with an arterial pressure-based cardiac output measurement system.
Results: VO2, VCO2, and DO2 decreased significantly from T1 to T2 and T3 [VO2/body surface area (BSA) (ml/min/m2): T1, 130 (122-146); T2, 107 (83-139); T3, 97 (93-121); p = 0.011], [VCO2/BSA (ml/min/m2): T1, 115 (105-129); T2, 90 (71-107); T3, 81 (69-101); p = 0.011], [DO2/BSA (ml/min/m2): T1, 467 (395-582); T2, 347 (286-392); T3, 382 (238-414); p = 0.0020]. Among the study subjects, a subset exhibited minimal reduction in VCO2. Although the respiratory frequency was titrated on the basis of end-tidal CO2 levels, there was no significant difference between the groups.
Conclusion: General anesthetic induction with remimazolam decreased VO2, VCO2, and DO2.
期刊介绍：
The Journal of Anesthesia is the official journal of the Japanese Society of Anesthesiologists. This journal publishes original articles, review articles, special articles, clinical reports, short communications, letters to the editor, and book and multimedia reviews. The editors welcome the submission of manuscripts devoted to anesthesia and related topics from any country of the world. Membership in the Society is not a prerequisite.
The Journal of Anesthesia (JA) welcomes case reports that show unique cases in perioperative medicine, intensive care, emergency medicine, and pain management.
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