The implications of arterial Po2 oscillations for conventional arterial blood gas analysis

Pfeiffer, Birgit; Syring, Rebecca S; Markstaller, Klaus; Otto, Cynthia M; Baumgardner, James E (2006). The implications of arterial Po2 oscillations for conventional arterial blood gas analysis. Anesthesia and analgesia, 102(6), pp. 1758-64. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1213/01.ane.0000208966.24695.30

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In a surfactant-depletion model of lung injury, tidal recruitment of atelectasis and changes in shunt fraction lead to large Pao2 oscillations. We investigated the effect of these oscillations on conventional arterial blood gas (ABG) results using different sampling techniques in ventilated rabbits. In each rabbit, 5 different ventilator settings were studied, 2 before saline lavage injury and 3 after lavage injury. Ventilator settings were altered according to 5 different goals for the amplitude and mean value of brachiocephalic Pao2 oscillations, as guided by a fast responding intraarterial probe. ABG collection was timed to obtain the sample at the peak or trough of the Pao2 oscillations, or over several respiratory cycles. Before lung injury, oscillations were small and sample timing did not influence Pao2. After saline lavage, when Po2 fluctuations measured by the indwelling arterial Po2 probe confirmed tidal recruitment, Pao2 by ABG was significantly higher at peak (295 +/- 130 mm Hg) compared with trough (74 +/- 15 mm Hg) or mean (125 +/- 75 mm Hg). In early, mild lung injury after saline lavage, Pao2 can vary markedly during the respiratory cycle. When atelectasis is recruited with each breath, interpretation of changes in shunt fraction, based on conventional ABG analysis, should account for potentially large respiratory variations in arterial Po2.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Markstaller, Klaus Michael

ISSN:

0003-2999

ISBN:

16717322

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 14:49

Last Modified:

23 Jan 2018 12:18

Publisher DOI:

10.1213/01.ane.0000208966.24695.30

PubMed ID:

16717322

Web of Science ID:

000237859300030

URI:

https://boris.unibe.ch/id/eprint/20432 (FactScience: 3729)

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