Document Detail


Veno-arterial carbon dioxide and pH gradients and survival in critical illness.
MedLine Citation:
PMID:  7781668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies have shown that the veno-arterial gradient for carbon dioxide (dVApCO2) is increased in the case of low cardiac index (CI). In order to further investigate this matter 220 haemodynamic measurements from 34 patients with septic shock and from 28 patients in the post-operative state without sepsis were evaluated. The arteriovenous gradient for pH (dAVpH) was also evaluated. CI was found to be inversely correlated to both dVApCO2 and dAVpH when the two groups of patients were analysed separately (r = -0.76 and r = -0.78, P < 0.001 for the relationship between CI and dVApCO2, r = -0.58 and r = -0.69, P < 0.001 for the relationship between CI and dAVpH). When volume loading over 2h was used to increase CI, 58-66% of the patients in the two groups showed a decline in dVApCO2 > 10% when CI was increased by > 10%. The corresponding values for a reduction in dAVpH > 10% during volume loading was 36-52%. While dAVpH was found to be increased in non-survivors (n = 27) when compared to survivors (0.32 +/- 0.01 vs. 0.24 +/- 0.1, P < 0.05) at the second day in the IUC, dVApCO2 was not a significant predictor of mortality despite the fact that CI was found to be decreased in the non-survivors (3.5 +/- 0.94 vs. 4.3 +/- 1.0 L min-1 m-2, P < 0.01). In conclusion, the veno-arterial carbon dioxide gradient was found to be inversely correlated to cardiac performance in patients both in patients with septic shock and in non-septic post-operative patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
L Lind
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  25     ISSN:  0014-2972     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-07-20     Completed Date:  1995-07-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  201-5     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Aortic Aneurysm, Abdominal / mortality,  physiopathology*,  surgery
Arteries
Biological Markers
Carbon Dioxide / blood*
Critical Illness*
Humans
Hydrogen-Ion Concentration*
Oxygen / blood
Postoperative Period
Predictive Value of Tests
Prospective Studies
Shock, Septic / blood,  mortality,  physiopathology*
Survival Rate
Veins
Chemical
Reg. No./Substance:
0/Biological Markers; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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