A new oxygenation index for reflecting intrapulmonary shunting in patients undergoing open-heart surgery

Chest
Mohamad F El-Khatib, Ghassan W Jamaleddine

Abstract

To assess the reliability of new and traditional oxygenation measurements in reflecting intrapulmonary shunt. Prospective study. Cardiac surgery unit at a university hospital. Fifty-five patients undergoing coronary artery bypass grafting. Simultaneous blood samples were collected from an indwelling arterial line and a catheter for determination of blood gases. Standard accepted formulas were utilized to measure a new oxygenation index: PaO(2)/fraction of inspired oxygen (FIO(2)) x mean airway pressure (Paw). The standard formulas used were the oxygenation ratio (PaO(2)/FIO(2)), PaO(2)/alveolar partial oxygen pressure (PAO(2)), alveolar-arterial oxygen tension gradient (P[A-a]O(2)), and intrapulmonary shunt (venous admixture [Qsp/Qt]). There were significant negative (p < 0.05) correlations between the PaO(2)/(FIO(2) x Paw) and Qsp/Qt (r = - 0.85), between the PaO(2)/FIO(2) and Qsp/Qt (r = - 0.74), and between the PaO(2)/PAO(2) and Qsp/Qt (r = - 0.71). There was a significant positive (p < 0.05) correlation between the P(A-a)O(2) gradient and Qsp/Qt (r = 0.66). However, the correlation was strongest between the PaO(2)/(FIO(2) x Paw) and Qsp/Qt. In this group of patients, PaO(2)/(FIO(2) x Paw) might be more reliable than other o...Continue Reading

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Citations

Jan 7, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Giuseppe A Marraro
Mar 5, 2008·American Journal of Respiratory and Critical Care Medicine·Mohamad F El-Khatib
Mar 4, 2008·Critical Care : the Official Journal of the Critical Care Forum·Mohamad F El-Khatib, Gassan W Jamaleddine
Aug 2, 2011·Saudi Journal of Anaesthesia·Aloka Samantaray, Nathan Hemanth
Jan 25, 2014·The Journal of Trauma and Acute Care Surgery·Ronald E DechertRobert H Bartlett
Mar 21, 2009·Journal of Clinical Monitoring and Computing·Yoshifumi KotakeHideyuki Shimizu
Feb 4, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Saeed YacoubyEmad Mossad
Jan 20, 2015·Critical Care Medicine·Michael J Lanspa, Alan H Morris
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Apr 30, 2017·Expert Review of Respiratory Medicine·Pongdhep TheerawitPaolo Pelosi
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May 8, 2020·European Journal of Anaesthesiology·Lennart Edmark, Erland Östberg
May 8, 2020·European Journal of Anaesthesiology·Eun Hee Chun, Hee Jung Baik

Related Concepts

Adaptation, Physiological
Coronary Artery Bypass Surgery
Blood Gas Analysis
Carbon Dioxide
Coronary Heart Disease
Hospitals, University
Oximetry, Pulse
Positive End-Expiratory Pressure
Postoperative Procedures
Probability

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