Regional venous-arterial CO2 to arterial-venous O2 content difference ratio in experimental circulatory shock and hypoxia.

Corrêa, Thiago Domingos; Pereira, Adriano José; Takala, Jukka; Jakob, Stephan Mathias (2020). Regional venous-arterial CO2 to arterial-venous O2 content difference ratio in experimental circulatory shock and hypoxia. Intensive care medicine experimental, 8(1), p. 64. Springer 10.1186/s40635-020-00353-9

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BACKGROUND

Venous-arterial carbon dioxide (CO2) to arterial-venous oxygen (O2) content difference ratio (Cv-aCO2/Ca-vO2) > 1 is supposed to be both sensitive and specific for anaerobic metabolism. What regional hemodynamic and metabolic parameters determine the ratio has not been clarified.

OBJECTIVES

To address determinants of systemic and renal, spleen, gut and liver Cv-aCO2/Ca-vO2.

METHODS

Post hoc analysis of original data from published experimental studies aimed to address effects of different fluid resuscitation strategies on oxygen transport, lactate metabolism and organ dysfunction in fecal peritonitis and endotoxin infusion, and from animals in cardiac tamponade or hypoxic hypoxia. Systemic and regional hemodynamics, blood flow, lactate uptake, carbon dioxide and oxygen-derived variables were determined. Generalized estimating equations (GEE) were fit to assess contributors to systemic and regional Cv-aCO2/Ca-vO2.

RESULTS

Median (range) of pooled systemic Cv-aCO2/Ca-vO2 in 64 pigs was 1.02 (0.02 to 3.84). While parameters reflecting regional lactate exchange were variably associated with the respective regional Cv-aCO2/Ca-vO2 ratios, only regional ratios were independently correlated with systemic ratio: renal Cv-aCO2 /Ca-vO2 (β = 0.148, 95% CI 0.062 to 0.234; p = 0.001), spleen Cv-aCO2/Ca-vO2 (β = 0.065, 95% CI 0.002 to 0.127; p = 0.042), gut Cv-aCO2/Ca-vO2 (β = 0.117, 95% CI 0.025 to 0.209; p = 0.013), liver Cv-aCO2/Ca-vO2 (β = - 0.159, 95% CI - 0.297 to - 0.022; p = 0.023), hepatosplanchnic Cv-aCO2/Ca-vO2 (β = 0.495, 95% CI 0.205 to 0.786; p = 0.001).

CONCLUSION

In a mixed set of animals in different shock forms or during hypoxic injury, hepatosplanchnic Cv-aCO2/Ca-vO2 ratio had the strongest independent association with systemic Cv-aCO2/Ca-vO2, while no independent association was demonstrated for lactate or hemodynamic variables.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Corrêa, Thiago Domingos; Takala, Jukka and Jakob, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2197-425X

Publisher:

Springer

Language:

English

Submitter:

Jsabelle Arni

Date Deposited:

09 Nov 2020 07:54

Last Modified:

15 Nov 2020 02:45

Publisher DOI:

10.1186/s40635-020-00353-9

PubMed ID:

33119834

Uncontrolled Keywords:

Carbon dioxide Hypoxia Lactate Lactate kinetics Multiple organ failure Oxygen consumption Resuscitation Septic shock

BORIS DOI:

10.7892/boris.147705

URI:

https://boris.unibe.ch/id/eprint/147705

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