Inadvertent Hyperventilation During Intraoperative Anesthetic Care in the Pediatric Population

Abstract

Background. Recent clinical data suggest that inadvertent intraoperative hyperventilation may have long-lasting deleterious effects during the postoperative period with the potential for exaggerating the respiratory depressant effect of opioids. The current study identified the incidence of inadvertent hyperventilation during intraoperative anesthetic care in a cohort of pediatric patients. Methods. A retrospective review of the electronic medical record system was performed on patients undergoing posterior spinal fusion. These patients were chosen as arterial blood gas (ABG) analysis is routinely performed for such cases. ABG data were analyzed for the occurrence of hyperventilation, defined as alkalosis (pH ≥ 7.45) concurrent with hypocarbia (PaCo2 ≤ 35 mm Hg). Results. The study cohort included 166 patients who ranged in age from 22 months to 21 years. There were a total of 452 ABG samples obtained. Hyperventilation with the combination of alkalosis and hypocarbia was noted in 40 of the 452 (9%) ABG sa...