{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T07:52:15Z","timestamp":1740124335895,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,10,16]],"date-time":"2017-10-16T00:00:00Z","timestamp":1508112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005689","name":"G\u00f6teborgs L\u00e4kares\u00e4llskap","doi-asserted-by":"publisher","award":["GLS\u2010588681"],"award-info":[{"award-number":["GLS\u2010588681"]}],"id":[{"id":"10.13039\/501100005689","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Isocapnic hyperventilation (<jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content>) is a method that shortens time to extubation after inhalation anaesthesia using hyperventilation (<jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content>) without lowering airway <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub>. In a clinical trial on patients undergoing long\u2010duration sevoflurane anaesthesia for major ear\u2013nose\u2013throat (<jats:styled-content style=\"fixed-case\">ENT<\/jats:styled-content>) surgery, we evaluated the utility of a technique for <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> delivery (<jats:styled-content style=\"fixed-case\">DCO<\/jats:styled-content><jats:sub>2<\/jats:sub>) to the inspiratory limb of a closed breathing circuit, during <jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content>, to achieve isocapnia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen adult <jats:styled-content style=\"fixed-case\">ASA<\/jats:styled-content> 1\u20133 patients were included. After end of surgery, mechanical <jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content> was started by doubling baseline minute ventilation. Simultaneously, <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> was delivered and dosed using a nomogram developed in a previous experimental study. Time to extubation and eye opening was recorded. Inspired (<jats:styled-content style=\"fixed-case\">FICO<\/jats:styled-content><jats:sub>2<\/jats:sub>) and expired (<jats:styled-content style=\"fixed-case\">FETCO<\/jats:styled-content><jats:sub>2<\/jats:sub>) <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> and arterial <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> levels were monitored during <jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content>. Cognition was tested pre\u2010operatively and at 20, 40 and 60 min after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A <jats:styled-content style=\"fixed-case\">DCO<\/jats:styled-content><jats:sub>2<\/jats:sub> of 285 \u00b1 45 ml\/min provided stable isocapnia during <jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content> (13.5 \u00b1 4.1 l\/min). The corresponding <jats:styled-content style=\"fixed-case\">FICO<\/jats:styled-content><jats:sub>2<\/jats:sub> level was 3.0 \u00b1 0.3%. Time from turning off the vaporizer (1.3 \u00b1 0.1 <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>age) to extubation (0.2 \u00b1 0.1 <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>age) was 11.3 \u00b1 1.8 min after 342 \u00b1 131 min of anaesthesia. Pa<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content><jats:sub>2<\/jats:sub> and <jats:styled-content style=\"fixed-case\">FETCO<\/jats:styled-content><jats:sub>2<\/jats:sub> remained at normal levels during and after <jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content>. In 85% of the patients, post\u2010operative cognition returned to pre\u2010operative values within 60 min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this cohort of patients, a <jats:styled-content style=\"fixed-case\">DCO<\/jats:styled-content><jats:sub>2<\/jats:sub> nomogram for <jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content> was validated. The patients were safely extubated shortly after discontinuing long\u2010term sevoflurane anaesthesia. Perioperatively, there were no adverse effects on arterial blood gases or post\u2010operative cognition. This technique for <jats:styled-content style=\"fixed-case\">IHV<\/jats:styled-content> can potentially be used to decrease emergence time from inhalation anaesthesia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13008","type":"journal-article","created":{"date-parts":[[2017,10,16]],"date-time":"2017-10-16T11:20:42Z","timestamp":1508152842000},"page":"186-195","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of a method for isocapnic hyperventilation: a clinical pilot trial"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-8497","authenticated-orcid":false,"given":"K.","family":"Hall\u00e9n","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine Institute of Clinical Sciences The Sahlgrenska Academy Gothenburg University Gothenburg 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