Document Detail


The implications of arterial Po2 oscillations for conventional arterial blood gas analysis.
MedLine Citation:
PMID:  16717322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Birgit Pfeiffer; Rebecca S Syring; Klaus Markstaller; Cynthia M Otto; James E Baumgardner
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  102     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-23     Completed Date:  2006-07-31     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1758-64     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia, Section of Critical Care, School of Veterinary Medicine, Center for Sleep and Respiratory Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Arteries
Blood Gas Analysis*
Bronchoalveolar Lavage
Disease Models, Animal
Female
Oxygen / blood*
Pulmonary Alveoli / physiopathology
Pulmonary Atelectasis / blood,  physiopathology,  therapy
Rabbits
Respiration, Artificial*
Respiratory Distress Syndrome, Adult / blood*,  physiopathology,  therapy
Sodium Chloride
Tidal Volume
Grant Support
ID/Acronym/Agency:
GM59274/GM/NIGMS NIH HHS; HL59052/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
7647-14-5/Sodium Chloride; 7782-44-7/Oxygen

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


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