PMID: 9421856Jan 9, 1998Paper

End-tidal partial pressure of carbon dioxide as a noninvasive indicator of systemic oxygen supply dependency during hemorrhagic shock and resuscitation

Shock
J A GuzmanJ A Kruse

Abstract

When oxygen delivery (DO2) critically decreases, oxygen consumption (VO2) becomes supply dependent. We examined whether end-tidal PCO2 (PetCO2) would identify supply dependency during shock. Five dogs (Group I) underwent progressive hemorrhage to decrease DO2 until they could no longer maintain a stable blood pressure. Five additional animals (Group II) were bled until VO2 decreased to 70% of baseline, followed by resuscitation. The PetCO2 versus time inflection point was compared with the DO2 at onset of supply dependency (DO2crit). DO2crit for Groups I and II were 6.9 +/- .4 and 8.1 +/- 1.3, respectively (p = NS), and not statistically different from the DO2 values at which PetCO2 decreased (6.6 +/- .7 and 6.3 +/- .7 mL/kg per min, respectively). AT constant minute volume, PetCO2 effectively indicated the onset of supply dependency and rapidly increased during resuscitation, paralleling the changes in VO2 in this model of hemorrhagic shock.

Citations

Apr 13, 1999·Critical Care Medicine·J A Kruse
Aug 23, 2007·Emergency Medicine Journal : EMJ·Dejan Kupnik, Pavel Skok
Mar 28, 2012·Annals of Intensive Care·Manuel Ignacio Monge GarcíaJuan Carlos Díaz Monrové
Jan 18, 2014·Shock·Kouhyar TavakolianAndrew P Blaber
Oct 3, 2006·Current Opinion in Anaesthesiology·Y MorimotoS Gando
Apr 27, 2010·Resuscitation·Kevin R WardVictor A Convertino
Jun 5, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Michael S AvidanMichael Pasque
Dec 17, 2014·British Journal of Anaesthesia·P-G GuinotH Dupont
Oct 30, 2004·American Journal of Physiology. Heart and Circulatory Physiology·Ivo P Torres FilhoKevin R Ward

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