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Early detection of cardiovascular instability by monitoring oxygen uptake and carbon dioxide production

The oxygen uptake and carbon dioxide production were measured in 21 patients in sepsis during conventional hemodynamic resuscitation. We assumed that in the state of low oxygen delivery, carbon dioxide is increasingly eliminated from the body. We hypothesized that this condition can be recognized from the VCO2/VO2 relationship.

VO2 and VCO2 were measured by analysis of expired gas by metabolic monitor; hemodynamics was monitored by pulmonary artery catheter. Cardiac output was determined by thermodilution, oxygen transport variables were gauged according to standard formulas using samples from peripheral arterial and mixed venous blood from pulmonary artery.

The patients were monitored for 6 hours. Lower values of VO2 were followed with higher values of VCO2. There was a high coefficient of negative correlation between cardiac index and respiratory quotient (r = -0.85; P = 0.002). The similar correlation, as expected, was found between oxygen delivery and respiratory quotient (r = -0.75; P = 0.01). The positive correlation was detected between respiratory quotient and venous–arterial CO2 difference (v–aDCO2) (r = 0.79; P = 0.016).

Our preliminary conclusion was that cardiovascular instability in patients with sepsis can be recognized from variations in VO2 and respiratory quotient.

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Pilas, V., Vucic, N. & Cala, K. Early detection of cardiovascular instability by monitoring oxygen uptake and carbon dioxide production. Crit Care 7, P191 (2003). https://doi.org/10.1186/cc2080

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  • DOI: https://doi.org/10.1186/cc2080

Keywords

  • Pulmonary Artery
  • Oxygen Uptake
  • Cardiac Index
  • Oxygen Delivery
  • Oxygen Transport