Value of the venous-arterial PCO2 gradient to reflect the oxygen supply to demand in humans: effects of dobutamine

Critical Care Medicine
Jean-Louis TeboulC Richard

Abstract

To test the value of venous-arterial PCO2 gradient (deltaPCO2) measurements to reflect the adequacy of cardiac index (CI) to oxygen demand in patients submitted to rapid changes of CI and oxygen demand. Prospective, comparative study. Medical intensive care unit of a university hospital. Ten patients with congestive heart failure exhibiting low baseline CI (< or =2.5 L/min/m2) but no evidence of global tissue hypoxia, as attested by the absence of clinical signs of shock and by normal blood lactate concentrations. Infusion of incremental doses of dobutamine: 0 (D0), 5 (D5), 10 (D10), and 15 (D15) microg/kg/min. The CI increased by a linear fashion from D0 (1.6+/-0.1 L/min/m2) to D15 (2.4+/-0.2 L/min/m2) (p< .05). The mixed venous oxygen saturation (SVO2) increased from D0 (49+/-2%) to D10 (61+/-2%) (p < .05) and remained unchanged from D10 to D15 (60+/-2%). The oxygen extraction ratio (O2 ER) and the deltaPCO2 decreased from D0 (48+/-2% and 9+/-1 torr [1.2+/-0.3 kPa], respectively) to D10 (36+/-2% and 5+/-1 torr [0.7+/-0.1 kPa], respectively) (p < .05 for both comparisons) and remained unchanged from D10 to D15 (36+/-2% and 6+/-1 torr [0.8+/-0.1 kPa], respectively). The biphasic courses of SVO2, O2 ER, and deltaPCO2 were relate...Continue Reading

References

Jan 1, 1992·Clinical Science·C J GreenI T Campbell
Sep 1, 1992·British Journal of Anaesthesia·S B BhattM Mak
Jun 1, 1990·Critical Care Medicine·C E MecherM H Weil
Jul 1, 1990·The American Review of Respiratory Disease·J L VincentR J Kahn
Apr 1, 1995·Critical Care Medicine·A UusaroJ Takala
Oct 1, 1993·The American Review of Respiratory Disease·H Zhang, J L Vincent

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Citations

Jul 26, 2012·Journal of Clinical Monitoring and Computing·Martin DresJean-Louis Teboul
Jul 11, 1998·Critical Care Medicine·A B Groeneveld
Oct 6, 2010·Critical Care : the Official Journal of the Critical Care Forum·Emmanuel Futier, Benoit Vallet
Dec 17, 2010·Croatian Medical Journal·Rosana TroskotInes Mrakovčić-Šutić
Dec 18, 2013·Critical Care : the Official Journal of the Critical Care Forum·Gustavo A Ospina-TascónGlenn Hernández
Apr 7, 2005·Intensive Care Medicine·Andrea MorelliPaolo Pietropaoli
Nov 22, 2011·Journal of Clinical Monitoring and Computing·Thomas John Morgan
Sep 13, 2012·Critical Care Research and Practice·Eric KipnisRonan Thibault
Oct 19, 2011·Anesthesiology Research and Practice·João M SilvaLuiz M Sá Malbouisson
Nov 14, 2014·Journal of Clinical Monitoring and Computing·Pierre-Eric DaninKarim Bendjelid
May 15, 2015·Critical Care : the Official Journal of the Critical Care Forum·Emmanuel RobinBenoit Vallet
Jun 12, 2016·Journal of Clinical Monitoring and Computing·Jerome MorelFrederic Costes
Jun 2, 2017·Annals of the American Thoracic Society·Boulos S Nassar, Gregory A Schmidt
Feb 9, 2016·World Journal of Critical Care Medicine·Jihad MallatDidier Thevenin
May 2, 2014·Journal of the American Heart Association·Matthew R MurninUNKNOWN Post Cardiac Arrest Service
Mar 24, 2017·Journal of Intensive Care·Ahmed HasaninHeba Nassar
Nov 19, 2015·Intensive Care Medicine·Gustavo A Ospina-TascónDaniel De Backer
Sep 1, 2021·Critical Care : the Official Journal of the Critical Care Forum·Zied LtaiefLucas Liaudet

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