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Normocapnia (10Ns)

This page is part of the 10N-Matrix for a high quality conduct of pediatric anesthesia care.

←  previous (Normoxemia)      |       next (Normonatremia)  →

Definition

Maintenance of expected arterial carbon dioxide tension.

Importance

Blood arterial carbon dioxide tensions are modified during anesthesia. Changes in arterial carbon dioxide tensions significantly affect body homeostasis including the acid-base status, the sympathomimetic tone and organ blood flow.

Consequences

Acute and chronic changes in arterial carbon dioxide tensions lead to short- and long-term outcomes:

  • modulation of vasoreactivity
  • central nervous system damage
  • neuro-behavioral changes

Prevention and treatment

  • aim to achieve adequate carbon dioxide tensions
  • acute changes in carbon dioxide tensions are commonly a result of difficulties and critical incidences during airway and ventilation management.

Prevention requires:

  • regular teaching and training of ventilation strategies
  • consider limitations of monitoring and airway equipment
  • use cuffed endotracheal tubes if appropriate
  • recognize discrepancies between arterial and end-tidal carbon dioxide tensions

 

  • Establish regulation for delivery of adequate ventilation management
  • Avoid acute high amplitude fluctuations of arterial carbon dioxide tension

Key references

  1. Ringer SK, Clausen NG, Spielmann N, Weiss M. Effects of moderate and severe hypocapnia on intracerebral perfusion and brain tissue oxygenation in piglets. Paediatr Anaesth. 2019 Nov;29(11):1114-1121
  2. Rhondali O, Juhel S, Mathews S, Cellier Q, Desgranges FP, Mahr A, De Queiroz M, Pouyau A, Rhzioual-Berrada K, Chassard D. Impact of sevoflurane anesthesia on brain oxygenation in children younger than 2 years. Paediatr Anaesth. 2014 Jul;24(7):734-40.

 


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Review all 10N

  • No Fear / No Awareness
  • Normovolemia
  • Normotension
  • Normal Heart Rate
  • Normoxemia
  • Normocapnia
  • Normonatremia
  • Normoglycemia
  • Normothermia
  • No Postoperative Discomfort:
    • No Pain
    • No PONV
    • No Emergence Delirium

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