Drug reference

carbon dioxide

Therapeutic gas

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

—

not curated

Mechanism

Rapid, potent stimulus to ventilation by acidifying central chemoreceptors and peripheral carotid bodies. Direct local effects on circulation include diminished cardiac contractility and systemic vasodilation.

Indications

insufflation during endoscopic procedures (e.g., laparoscopic surgery)flooding the surgical field during cardiac surgeryadjusting pH during cardiopulmonary bypass proceduresshort-term hypocarbia to diminish intracranial hypertension

Dosing

Adult: 5% to 10% in combination with O2 by face mask

Contraindications

sustained hypocarbia (associated with worse outcomes in patients with head injury)

Side effects

Common

increased cardiac outputincreased heart rateincreased blood pressure

Serious

respiratory acidosis (with increased Pco2)
central depression (can worsen respiratory depression with narcotics/anesthetics)
cardiac arrhythmias (due to catecholamine release)