Central venous-arterial pCO2 difference identifies microcirculatory hypoperfusion in cardiac surgical patients with normal central venous oxygen saturation: A retrospective analysis

Journal of Cardiothoracic and Vascular Anesthesia

Volumn 29, Issue 3, 2015, Pages 646-655

  Habicher, Marit ^a   Von Heymann, Christian ^a   Spies, Claudia D ^a   Wernecke, Klaus Dieter ^b   Sander, Michael ^a  

^a CHARITÉ UNIVERSITÄTSMEDIZIN BERLIN   (Germany)

^b SOSTANA GMBH   (Germany)

Author keywords

cardiac surgery; central venous arterial pCO2 difference; microcirculatory hypoperfusion; splanchnic hypoperfusion

Indexed keywords

INDOCYANINE GREEN; LACTIC ACID; CARBON DIOXIDE;

ADULT; AGED; ARTICLE; ARTIFICIAL VENTILATION; BLOOD GAS ANALYSIS; CARBON DIOXIDE TENSION; CARDIAC PATIENT; CARDIOPULMONARY BYPASS; CENTRAL VENOUS ARTERIAL CARBON DIOXIDE TENSION; COMPARATIVE STUDY; CORONARY ARTERY BYPASS GRAFT; FEMALE; HEART PERFUSION; HUMAN; INTENSIVE CARE UNIT; INTERVENTION STUDY; MAJOR CLINICAL STUDY; MALE; MICROCIRCULATION; OXYGEN SATURATION; PRIORITY JOURNAL; PROSPECTIVE STUDY; RETROSPECTIVE STUDY; SURGICAL PATIENT; UNIVERSITY HOSPITAL; VENOUS OXYGEN TENSION; ADVERSE EFFECTS; BLOOD; CENTRAL VENOUS CATHETERIZATION; HEART SURGERY; MIDDLE AGED; OXIMETRY; OXYGEN CONSUMPTION; PHYSIOLOGY; PROCEDURES; TRENDS;

AGED; BLOOD GAS ANALYSIS; CARBON DIOXIDE; CARDIAC SURGICAL PROCEDURES; CARDIOPULMONARY BYPASS; CATHETERIZATION, CENTRAL VENOUS; FEMALE; HUMANS; MALE; MICROCIRCULATION; MIDDLE AGED; OXIMETRY; OXYGEN CONSUMPTION; PROSPECTIVE STUDIES; RETROSPECTIVE STUDIES;

EID: 84930090912     PISSN: 10530770     EISSN: 15328422     Source Type: Journal    
DOI: 10.1053/j.jvca.2014.09.006     Document Type: Article

References (35)

1. M.A. Hamilton, M. Cecconi, and A. Rhodes A systematic review and meta-analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate and high-risk surgical patients Anesth Analg 112 2011 1392 1402
2. M. Carl, A. Alms, and J. Braun S3 guidelines for intensive care in cardiac surgery patients: hemodynamic monitoring and cardiocirculary system Ger Med Sci 2010 Jun 15
3. J. Textoris, L. Fouché, and S. Wiramus High central venous oxygen saturation in the latter stages of septic shock is associated with increased mortality Crit Care 15 2011 R176
4. J.V. Pope, A.E. Jones, and D.F. Gaieski Multicenter study of central venous oxygen saturation (ScvO(2)) as a predictor of mortality in patients with sepsis Ann Emerg Med 55 2010 40 46 e1
5. G. Dong, C. Liu, and B. Xu Postoperative abdominal complications after cardiopulmonary bypass J Cardiothorac Surg 7 2012 1-1
6. M.J. Ott, T.G. Buchman, and W.A. Baumgartner Postoperative abdominal complications in cardiopulmonary bypass patients: a case-controlled study Ann Thorac Surg 59 1995 1210 1213
7. S.K. Ohri, I. Bjarnason, and V. Pathi Cardiopulmonary bypass impairs small intestinal transport and increases cut permeability Ann Thorac Surg 55 1993 1080 1086
8. M. Ariza, J.W. Gothard, and P. Macnaughton Blood lactate and mixed venous-arterial PCO2 gradient as indices of poor peripheral perfusion following cardiopulmonary bypass surgery Intensive Care Med 17 1991 320 324
9. J. Bakker, J. Vincent, and P. Gris Veno-arterial carbon dioxide gradient in human septic shock Chest 101 1992 509 515
10. J. Cuschieri, E.P. Rivers, and M.W. Donnino Central venous-arterial carbon dioxide difference as an indicator of cardiac index Intensive Care Med 31 2005 818 822
11. F. Vallée, B. Vallet, and O. Mathe Central venous-to-arterial carbon dioxide difference: an additional target for goal-directed therapy in septic shock? Intensive Care Med 34 2008 2218 2225
12. E. Futier, E. Robin, and M. Jabaudon Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery Crit Care 14 2010 R193
13. J.M. Silva, AMRR Oliveira, and J.L. Segura A large venous-arterial PCO(2) is associated with poor outcomes in surgical patients Anesthes Res Prac 2011 2011 759792
14. G. Hernandez, T. Regueira, and A. Bruhn Relationship of systemic, hepatosplanchnic, and microcirculatory perfusion parameters with 6-hour lactate clearance in hyperdynamic septic shock patients: an acute, clinical-physiological, pilot study Ann Intensive Care 2 2012 1 9
15. C. von Heymann, M. Sander, and A. Foer The impact of an hematocrit of 20% during normothermic cardiopulmonary bypass for elective low risk coronary artery bypass graft surgery on oxygen delivery and clinical outcome - a randomized controlled study [ISRCTN35655335] Crit Care 10 2006 R58
16. M. Sander, C.D. Spies, and K. Berger Perioperative indocyanine green clearance is predictive for prolonged intensive care unit stay after coronary artery bypass grafting - an observational study Crit Care 13 2009 R149
17. R.P. Dellinger, M.M. Levy, and A. Rhodes Surviving Sepsis Campaign Crit Care Med 41 2013 580 637
18. R. Durkin, M.A. Gergits, and J.F. Reed The relationship between the arteriovenous carbon dioxide gradient and cardiac index J Crit Care 8 1993 217 221
19. B. Lamia, X. Monnet, and J.L. Teboul Meaning of arterio-venous PCO2 difference in circulatory shock Minerva Anestesiol 72 2006 597 604
20. W. Grundler, M.H. Weil, and E.C. Rackow Arteriovenous carbon dioxide and pH gradients during cardiac arrest Circulation 74 1986 1071 1074
21. M.H. Weil, E.C. Rackow, and R. Trevino Difference in acid-base state between venous and arterial blood during cardiopulmonary resuscitation N Engl J Med 315 1986 153 156
22. A.B. Groeneveld Interpreting the venous-arterial PCO2 difference Crit Care Med 26 1998 979 980
23. R. Schlichtig, and S.A. Bowles Distinguishing between aerobic and anaerobic appearance of dissolved CO2 in intestine during low flow J Appl Physiol 76 1994 2443 2451
24. B.A. Johnson, and M.H. Weil Redefining ischemia due to circulatory failure as dual defects of oxygen deficits and of carbon dioxide excesses Crit Care Med 19 1991 1432 1438
25. H. Zhang, and J.-L. Vincent Arteriovenous Differences in pCO2 and pH are good indicators of critical hypoperfusion American Review of Respiratory Disease 148 1993 867 871
26. H.J. Adrogué, M.N. Rashad, and A.B. Gorin Assessing acid-base status in circulatory failure. Differences between arterial and central venous blood N Engl J Med 320 1989 1312 1316
27. M. Sander, C.D. Spies, and A. Foer Agreement of central venous saturation and mixed venous saturation in cardiac surgery patients Intensive Care Med 33 2007 1719 1725
28. A. Nygren, A. Thorén, and S.E. Ricksten Vasopressin decreases intestinal mucosal perfusion: a clinical study on cardiac surgery patients in vasodilatory shock Acta Anaesthesiol Scand 53 2009 581 588
29. A. Meier-Hellmann, K. Reinhart, and D.L. Bredle Epinephrine impairs splanchnic perfusion in septic shock Crit Care Med 25 1997 399 404
30. K. Reinhart, T. Rudolph, and D.L. Bredle Comparison of central-venous to mixed-venous oxygen saturation during changes in oxygen supply/demand Chest 95 1989 1216 1221
31. M.G. Mythen, and A.R. Webb The role of gut mucosal hypoperfusion in the pathogenesis of post-operative organ dysfunction Intensive Care Med 20 1994 203 209
32. S. Kimura, T. Yoshioka, and M. Shibuya Indocyanine green elimination rate detects hepatocellular dysfunction early in septic shock and correlates with survival Crit Care Med 29 2001 1159 1163
33. J. Birnbaum, C. Lehmann, and K. Taymoorian The effect of dopexamine and iloprost on plasma disappearance rate of indocyanine green in patients in septic shock [in German] Anaesthesist 52 2003 1014 1019
34. M. Sander, C.D. Spies, and A. Foer Peri-operative plasma disappearance rate of indocyanine green after coronary artery bypass surgery Cardiovasc J Africa 18 2007 375 379
35. J. Holland, M. Carey, and N. Hughes Intraoperative splanchnic hypoperfusion, increased intestinal permeability, down-regulation of monocyte class II major histocompatibility complex expression, exaggerated acute phase response, and sepsis Am J Surg 190 2005 393 400