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Especially arterial carbon dioxide pressures (PaCO\n                      <jats:sub>2<\/jats:sub>\n                      ) impact cerebral blood flow. Only extensive changes in end-tidal CO\n                      <jats:sub>2<\/jats:sub>\n                      have been studied so far. The aim of this study was to evaluate the impact of mild hypo- and hyperventilation on cerebral blood flow as assessed by regional cerebral red blood cell oxygen saturation (rSO\n                      <jats:sub>2<\/jats:sub>\n                      ) in two age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Two groups of patients were compared under general anesthesia before the surgical procedure was started: A younger patient group (age\u2009&lt;\u200940 years; YP) and older patients aged\u2009&gt;\u200960 years (OP). Anesthetic management was standardized. In both groups, end-tidal CO\n                      <jats:sub>2<\/jats:sub>\n                      was adjusted either to a low-normal value of 35\u201337 mmHg or a high-normal value of 43\u201345 mmHg for 15 min each. The sequence of these interventions was randomized. rSO\n                      <jats:sub>2<\/jats:sub>\n                      was estimated by near-infrared spectroscopy (NIRS). The primary outcome was defined as the difference in rSO2 between hypo- and hyperventilation between the two age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 78 patients were included. In both groups, there was a statistically significant difference in rSO2 values after 15 min of hypo- versus hyperventilation. In the YP-group, rSO\n                      <jats:sub>2<\/jats:sub>\n                      was 74\u2009\u00b1\u20094% after 15 min of hypoventilation and decreased to 68\u2009\u00b1\u20096% during hyperventilation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the OP-group, rSO\n                      <jats:sub>2<\/jats:sub>\n                      was 71\u2009\u00b1\u20095% and 65\u2009\u00b1\u20096%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There was no difference concerning changes in comparison of younger and elder patient groups (in both groups, \u0394 rSO\n                      <jats:sub>2<\/jats:sub>\n                      \u2009=\u20096\u2009\u00b1\u20093%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.732).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Even mild hypoventilation increased rSO\n                      <jats:sub>2<\/jats:sub>\n                      compared to mild hyperventilation and this difference occurred independent of age.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13741-025-00517-9","type":"journal-article","created":{"date-parts":[[2025,3,16]],"date-time":"2025-03-16T21:40:42Z","timestamp":1742161242000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of mild hypo- and hyperventilation on cerebral oxygen supply during general anesthesia"],"prefix":"10.1186","volume":"14","author":[{"given":"Philipp","family":"Groene","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Rapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Ninke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Conzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Hofmann-Kiefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"issue":"2","key":"517_CR1","doi-asserted-by":"publisher","first-page":"e298","DOI":"10.1016\/j.bja.2022.08.032","volume":"130","author":"E Ahrens","year":"2023","unstructured":"Ahrens E, Tartler TM, Suleiman A, Wachtendorf LJ, Ma H, Chen G, et al. 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The conclusion of the study is not altered by the changes.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2026","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s13741-026-00658-5","URL":"https:\/\/doi.org\/10.1186\/s13741-026-00658-5","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol had been approved by the Ludwig-Maximilians-University ethics committee (No 19\u2013920). The study was performed in accordance with the Declaration of Helsinki, with written informed consent being obtained from all participants before they undertook any of the study procedures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30"}}