| The effect of hypo-, normo-, and hypercapnia induced by mechanical ventilation on intrapulmonary shunt. | |
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MedLine Citation:
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PMID: 7800919 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effects of hypo-, normo- and hypercapnia on the variations in arterial oxygenation and their indices in critical patients with acute respiratory failure (ARF) receiving mechanical ventilation are studied. It is a prospective and randomized study carried out in multidisciplinary ICU. Fifteen ARF patients, intubated and mechanically ventilated, were studied within the first 48 h of evolution. Three stages were delimited: I) 30 min after the beginning of anaesthesia; II) 30 min after adding 30 cm of dead space (VD); III) 30 min after replacing the previous VD with VD of 60 cm. Ventilation parameters and FiO2 were kept stable. Stage I was characterized by respiratory alkalosis and stage II by normal acid-base balance with an increase in PaO2 (p < 0.01) and a decrease in intrapulmonary shunt (Qsp/Qt) (p < 0.001); the indices alveolar to arterial oxygen tension gradient [P(A-a)O2], respiratory index (R.I.) and estimated shunt (Est Shunt) also decreased significantly, whereas arterial to alveolar oxygen tension ratio (PaO2/PAO2) and arterial oxygen tension to inspired oxygen fraction ration (PaO2/FiO2) increased significantly. In stage III there was pure hypercapnic acidosis, with decreases in PAO2 (p < 0.001), P(A-a)O2 (p < 0.01) and R.I. (p < 0.05), while PaO2, Qsp/Qt, Est Shunt, PaO2/PAO2 and PaO2/FiO2 remained stable with respect to the previous situation. The observed PaO2 differs (p < 0.05) from the expected PaO2 in stage III. It is suggested that local or regional modifications of pulmonary perfusion are responsible for the observed variations. The P(A-a)O2 and R.I. indices do not make it possible to differentiate the causes of arterial hypoxemia in the presence of hypercapnia. |
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Authors:
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J H Boix; F Alvarez; M Tejeda; E Peydro; D Olivares; A Arnau |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Revista española de fisiología Volume: 50 ISSN: 0034-9402 ISO Abbreviation: Rev. Esp. Fisiol. Publication Date: 1994 Jun |
Date Detail:
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Created Date: 1995-01-20 Completed Date: 1995-01-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0404475 Medline TA: Rev Esp Fisiol Country: SPAIN |
Other Details:
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Languages: eng Pagination: 89-95 Citation Subset: IM; S |
Affiliation:
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UCI, Hospital, Castellón, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Alkalosis / blood, etiology, physiopathology* Carbon Dioxide / blood* Female Humans Hypercapnia / etiology, physiopathology* Hypocapnia / etiology, physiopathology* Male Middle Aged Oxygen / blood Partial Pressure Prospective Studies Respiration, Artificial / adverse effects* Respiratory Dead Space Respiratory Function Tests Respiratory Insufficiency / blood, physiopathology* |
| Chemical | |
Reg. No./Substance:
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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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