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Variations of veno-arterial and mucosal-arterial CO2 gap during continuous veno-venous hemodiafiltration

Introduction

Veno-arterial CO2 gap (P(v-a) CO2) and mucosal-arterial CO2) gap (P(g-a) CO2 may help to detect tissular dysoxia. Continuous veno-venous hemodiafiltration (CVVHD) technics are well tolerated in septics patients.

Objectives

Change of P(v-a) CO2 and of P(g-a) CO2 during CVVHD.

Methods

Prospective study. Intubated and ventilated patients. Hemodynamics and systemic oxygen derived parameters were collected before and during CVVHD (H0-H6). CVVHD setting parameters (PRISMA®, HOSPAL) were standardised. Gastric mucosal PCO2 continously monitored (NGS (TONOMETRICS) and TONOCAP® (DATEX). P(v-a) CO2 and P(g-a) CO2 calculated. Continuous measure of end tidal CO2 (PetCO2). Statistics: ANOVA, Scheffe t test for paired and unpaired values

Results

7 patients (71.7 ± 5 years, SAPS II = 59.5 ± 3.7) included. PetCO2 and P(v-a)CO2 did not change from H0 to H6. P (g-a)CO2 increased significantly at H1 (*P < 0.05) then progressively decrease but did not reach the initial value.

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Results

Conclusion

The marked increase of P(g-a)CO2 during CVVHD could be explained by acid-base status in the mucosa independent of hemodynamics changes.

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Chagnon, J., Lambiotte, F., Merlette, F. et al. Variations of veno-arterial and mucosal-arterial CO2 gap during continuous veno-venous hemodiafiltration. Crit Care 2, P133 (1998). https://doi.org/10.1186/cc262

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Keywords

  • Oxygen
  • Public Health
  • Emergency Medicine
  • Continuous Measure
  • Hemodynamic Change