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Research ArticleOriginal Article
Open Access

Effects of different fresh gas flows on carboxyhemoglobin levels: non-invasive carbon monoxide monitoring

A randomized clinical trial

Bengü G. Köksal, Gamze Küçükosman, Pişkin Özcan, Çağdaş Baytar, Keziban Bollucuoğlu, Rahşan D. Okyay and Hilal Ayoğlu
Saudi Medical Journal August 2022, 43 (8) 891-898; DOI: https://doi.org/10.15537/smj.2022.43.8.20220424
Bengü G. Köksal
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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  • For correspondence: [email protected]
Gamze Küçükosman
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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Pişkin Özcan
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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Çağdaş Baytar
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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Keziban Bollucuoğlu
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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Rahşan D. Okyay
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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Hilal Ayoğlu
From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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    Figure 1

    - Flow diagram of the study (CONSORT).

Tables

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    Table 1

    - Sociodemographic variables and intraoperative data.

    VariablesGroup H (n=32)Group L (n=32)P-values
    Age (year)41.90±9.8239.37±12.750.377
    BMI (kg/m2)25.65±3.3625.54±3.730.895
    Gender, female/male (n)14/1815/170.802
    ASA score I/II (n)15/1713/190.614
    Amount of cigarettes, pack/year (median)0.5 (0-45)2.5 (0-35)0.600
    Duration of surgery (minute)166.73±32.17184.13±41.470.075
    Duration of anesthesia (minute)175.16±32.50192.90±42.940.077
    Total remifentanil consumption (µg)1242.73±319.561377.80±392.940.150
    Total desflurane consumption (ml)263.43±135.0987.73±40.96<0.001
    • Values are presented as mean ± standard deviation (SD). BMI: body mass index, ASA: American Society of Anesthesiologists, µg: microgram, n: number of patient, Group L: low-flow anesthesia, Group H: high-flow anesthesia

    • View popup
    Table 2

    - Comparison of carboxyhemoglobin values by group, smoking status, and time.

    VariablesFDFP-values
    Group84,1321<0.001
    Smoking status191,5681<0.001
    Time11,707110.386
    Group - smoking status7,00210.008
    Group - time25,541110.008
    Smoking status - time37,1211<0.001
    Group - smoking status - time2,09110.998
    • DF: degrees of freedom, F: test statistic

    • View popup
    Table 3

    - Comparison of the mean carboxyhemoglobin values of the groups by time.

    TimeGroup HGroup LP-values*
    T0 COHb1.36±1.141.40±1.230.874
    T1 COHb1.11±1.061.12±1.320.983
    T2 COHb0.99±1.001.25±1.340.385
    T3 COHb0.85±0.931.36±1.350.085
    T4 COHb0.72±0.881.27±1.230.046
    T5 COHb0.60±0.761.26±1.100.007
    T6 COHb0.61±0.741.39±1.210.003
    T7 COHb0.65±0.731.30±1.050.006
    T8 COHb0.59±0.651.44±1.170.001
    T9 COHb0.51±0.631.45±1.24<0.001
    T10 COHb0.54±0.621.51±1.31<0.001
    T11 COHb0.54±0.611.58±1.38<0.001
    P-values**<0.05>0.05 

    Values are presented as mean ± standard deviation (SD).

    • ↵* Inter-group comparison,

    • ↵** intragroup comparison, Group H: high-flow group, Group L: low-flow group, COHb: carboxyhemoglobin

    • View popup
    Table 4

    - Comparison of carboxyhemoglobin values of groups according to smoking status.

    TimeGroup HGroup L
    Group I (n=12)Group II (n=20)P-valuesGroup III (n=9)Group IV (n=23)P-values
    T0 COHb2.23±0.880.49±0.41<0.0012.10±1.180.71±0.850.001
    T1 COHb1.80±1.080.43±0.41<0.0011.85±1.280.39±0.900.001
    T2 COHb1.50±1.150,47±0.400.0031.85±1.240,64±1.190.009
    T3 COHb1.26±1.120.43±0.400.0121.95±1.270.76±1.180.011
    T4 COHb1.19±0.980.26±0.420.0021.78±1.150.76±1.130.018
    T5 COHb0.98±0.840.21±0.410.0041.70±1.070.83±0.980.024
    T6 COHb0.91±0.870.31±0.440.0221.79±1.050.87±1.140.025
    T7 COHb0.85±0.850.45±0.530.0891.68±0.990.91±1.000.036
    T8 COHb0.72±0.740.45±0.530.2521.81±1.061.06±1.180.027
    T9 COHb0.64±0.720.38±0.500.3051.94±0.940.92±1.140.034
    T10 COHb0.70±0.700.38±0.500.5572.10±1.420.92±1.180.010
    T11 COHb0.70±0.680.37±0.500.6492.13±1.351.50±1.760.032
    P-values*<0.05>0.05 >0.05>0.05 

    Values are presented as mean ± standard deviation (SD).

    • ↵* Intragroup comparison, COHb: carboxyhemoglobin

    • View popup
    Table 5

    - Incidence of respiratory complications in the postanesthesia care unit: high-flow versus low-flow anesthesia.

    VariablesGroup H (n=32)Group L (n=32)P-values
    Complications
    No23 (71.9)29 (90.6)0.055
    Yes9 (28.1)3 (9.4) 
    Desaturation1 (3.1)0 (0.0)0.055
    (SpO2<92%)   
    Apnea/breath-holding1 (3.1)1 (3.1) 
    Coughing6 (18.8)2 (6.2)0.257
    Bronchospasm1 (3.1)0 (0.0) 
    Laryngospasm0 (0.0)0 (0.0)-
    • Values are presented as a number and precentage (%). SpO2: peripheral capillary oxygen saturation, Group L: low-flow group, Group H: high-flow group

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Saudi Medical Journal: 43 (8)
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Effects of different fresh gas flows on carboxyhemoglobin levels: non-invasive carbon monoxide monitoring
Bengü G. Köksal, Gamze Küçükosman, Pişkin Özcan, Çağdaş Baytar, Keziban Bollucuoğlu, Rahşan D. Okyay, Hilal Ayoğlu
Saudi Medical Journal Aug 2022, 43 (8) 891-898; DOI: 10.15537/smj.2022.43.8.20220424

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Effects of different fresh gas flows on carboxyhemoglobin levels: non-invasive carbon monoxide monitoring
Bengü G. Köksal, Gamze Küçükosman, Pişkin Özcan, Çağdaş Baytar, Keziban Bollucuoğlu, Rahşan D. Okyay, Hilal Ayoğlu
Saudi Medical Journal Aug 2022, 43 (8) 891-898; DOI: 10.15537/smj.2022.43.8.20220424
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Keywords

  • anesthesia
  • carbon monoxide
  • carboxyhemoglobin
  • cigarette smoking

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