====== End-tidal carbon dioxide ======


End-tidal [[carbon dioxide]] (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
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A [[retrospective]] [[review]] was conducted of consecutive patients from March 2020 to June 2021 who underwent [[mechanical thrombectomy]] for acute [[anterior circulation]] [[ischemic stroke]] under [[general anesthesia]] and achieved successful [[recanalization]] (Thrombolysis in [[Cerebral Infarction]] [[TICI]] ≥ 2b). Only patients with [[CT perfusion]], procedural [[ETCO2]], and postoperative MRI data were included. Segmentation [[software]] was used for multi-parametric image analysis. [[normocapnia]] defined as mean ETCO2 of 35 mmHg was used to dichotomize subjects. Univariate and multivariate statistics were applied.

Fifty-eight patients met criteria for analysis. Of these, 44 had TICI 3 recanalization, 9 had TICI 2c, and 5 had TICI 2b. Within this combined recanalization group, patients with mean ETCO2 > 35 had significantly higher rates of functional independence at 90 days. Although patients tended to salvage more penumbra and experience smaller final infarcts when ETCO2 exceeded 35 mmHg, this did not reach statistical significance.

[[Stroke]] patients who underwent successful [[thrombectomy]] with [[general anesthesia]] achieved higher rates of functional independence when procedural ETCO2 exceeded 35 mmHg. Further studies to confirm this effect and investigate optimal ETCO2 parameters should be considered
((Parr MS, Salehani A, Ogilvie M, Ethan Tabibian B, Rahm S, Hale AT, Tsemo GB, Aluri A, Kim J, Mathru M, Jones JGA. The effect of procedural end-tidal CO2 on infarct expansion during anterior circulation thrombectomy. Interv Neuroradiol. 2022 Dec 4:15910199221143175. doi: 10.1177/15910199221143175. Epub ahead of print. PMID: 36464668.))