Monitoring and treatment of refractory hypercapnia on elderly patients undergoing retroperitoneo-scopyic surgery

Background Because of the smaller trauma and faster postoperative recovery,the application of retroperitoneoseopic urologic surgery on elderly patients has become more and more popular.However,the elderly patients are more prone to serious hypercapnia due to the special features of retroperitoneoscopic surgery itself and the elderly patients' physiological functions,which threaten the elderly patients' lives.Objective To explore an effective method which could accurately monitor the arterial partial pressure of carbon dioxide (PaCO2) for hypercapnia during operations,and effectively control the ventilation on time.Content This article reviewed the mechanisms of hypercapnia on elderly patients undergoing prolonged retropentoneoscopyic surgery,the influence of hypercapnia on elderly patients' physiological functions and the methods of monitoring and treatment.Trend Transcutaneous partial pressure of carbon dioxide(TcPCO2) monitoring was feasible to predict the PaCO2 accurately in adults during different operations.Positive end-expiratory preassure (PEEP) has been proved to improve patients' ventilatory functions in some degree.Both methods may provide a new option for monitoring during retroperitoneoscopyic surgery. Key words: Retroperitoneo-scopyic surgery;  Elderly patient;  Refractory hypercapnia;  Transcutaneous partial pressure of carbon dioxide;  Monitoring;  Positive end-expiratory preassure