End‐tidal carbon dioxide during thoracotomy

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Abstract
Summary: The concentration of carbon dioxide in end‐tidal gas was compared with the tension in arterial or superior vena caval blood during thoracotomy in twelve patients. In six adults requiring pulmonary resection, one‐lung anaesthesia did not change the difference between the two measurements. In six children in whom a systemic to pulmonary arterial anastomosis was being created to improve pulmonary blood flow impaired by cyanotic congenital heart disease, occlusion of the pulmonary artery caused an increase in the blood‐end‐tidal carbon dioxide gradient. This change was particularly marked in two neonates and was of sufficient magnitude to render end‐tidal monitoring unreliable in these circumstances.