{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:24:52Z","timestamp":1753878292081,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Right ventricular (RV) failure is a serious complication after cardiac surgery. Postoperative hypercapnic acidosis can increase pulmonary arterial pressure (PAP) that can lead to RV dysfunction. We aimed to investigate whether hypoventilation\u2010induced hypercapnic acidosis leads to increased PAP levels and detectable changes in RV dimensions and function in postoperative cardiac surgery patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective open single\u2010center interventional cohort study was conducted on postoperative elective mitral valve prolapse repair surgery patients. Hemodynamically stable patients were studied during mechanical ventilation in the recovery room. We performed pulmonary arterial catheter (PAC) measurements and comprehensive transesophageal echocardiographic (TEE) assessment of the RV. Measurements were made in normocapnia (target PaCO<jats:sub>2<\/jats:sub> 5\u2009kPa) and in hypoventilation induced hypercapnia (target PaCO<jats:sub>2<\/jats:sub> 7.5\u2009kPa). A paired t\u2010test was used to compare the measured differences in the values under normo\u2010 and hypercapnia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altogether, 20 patients were included in the study. We achieved a significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) difference both in PaCO<jats:sub>2<\/jats:sub> levels; mean 5.0\u2009kPa (0.3) SD versus 7.8\u2009kPa (0.4) and in pH values; mean 7.40 (0.03) versus 7.24 (0.03). PAP\u2010values measured from the PAC significantly increased (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) in hypercapnia. Systolic pulmonary pressure rose from mean 30.2\u2009mmHg (8.4) to 44.2\u2009mmHg (9.3). Pulmonary vascular resistance was unchanged. In hypercapnic acidosis, we noticed a hyperdynamic state with significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) elevated cardiac output (mean 4.1\u2009L\/min [0.9] vs. 5.5\u2009L\/min [1.3]) and decreased systemic vascular resistance (mean 1402.2 dynes\/s\/cm<jats:sup>\u22125<\/jats:sup> [364.8] vs. 927.7 dynes\/s\/cm<jats:sup>\u22125<\/jats:sup> [260.3]). In the TEE study of the RV, increased PAP\u2010levels didn't cause detectable structural or functional changes indicating RV dysfunction or failure. Pulmonary arterial velocity time integral rose significantly (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) from mean 13.0\u2009cm (2.7) to 15.1\u2009cm (3.4) associated with the hyperdynamic state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In postoperative mitral valve repair surgery patients, hypercapnic acidosis caused increased PAP values measured from the PAC. The TEE study did not detect significant structural or functional changes in the RV despite the increase in PAP. From our findings, we can speculate that it would be possible to detect increased PAP with PAC earlier than by waiting for apparent TEE changes in RV function.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> Clinical trial number: NCT02757573, Principal investigator: Kati J\u00e4rvel\u00e4, Date of registration: April 20, 2016. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT02757573\">https:\/\/clinicaltrials.gov\/study\/NCT02757573<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70064","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T03:34:58Z","timestamp":1749526498000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Right Ventricular Response to Hypercapnia After Mitral Valve Repair: A Hemodynamic Assessment"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3018-1510","authenticated-orcid":false,"given":"Markus L. J.","family":"Tujunen","sequence":"first","affiliation":[{"name":"Department of Intensive Care Tampere University Hospital  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juha","family":"Lahti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Cardiac Anesthesia and Intensive Care Tampere University Heart Hospital Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heikki","family":"Kiiski","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Tampere University Hospital  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne H.","family":"Kuitunen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Tampere University Hospital  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suvi S.","family":"Tuohinen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Cardiac Anesthesia and Intensive Care Tampere University Heart Hospital Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kati","family":"Rautaneva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Anesthesia Tampere University Hospital  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ville L.","family":"Jalkanen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Tampere University Hospital  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-430X","authenticated-orcid":false,"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4286-933X","authenticated-orcid":false,"given":"Kati M.","family":"J\u00e4rvel\u00e4","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Cardiac Anesthesia and Intensive Care Tampere University Heart Hospital Center  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3283346c51"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2174\/157340308783565384"},{"key":"e_1_2_9_4_1","first-page":"185","article-title":"Postoperative Right Ventricular Failure in Cardiac Surgery","volume":"7","author":"Estrada V. 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