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Intensive Care Medicine

Published in:

01-03-2004 | Original

Effects of fluid challenge on gastric mucosal PCO₂ in septic patients

Authors: Eliézer Silva, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent

Published in: Intensive Care Medicine | Issue 3/2004

Abstract

Objective

To determine the effects of fluid challenge on systemic hemodynamic variables and gastric intramucosal partial pressure of carbon dioxide (PCO₂) in septic patients.

Design

Short-term interventional study.

Setting

Medical-surgical intensive care unit in a university hospital.

Patients

Twenty-four adult patients with severe sepsis or septic shock requiring volume replacement. All patients were studied within 24 h of onset of severe sepsis or septic shock.

Interventions

Five hundred milliliters of a 6% hydroxyethyl starch (HES) solution were administered in 30 min.

Measurements and results

Complete hemodynamic data, blood samples, and gastric mucosal PCO₂ (automatic gas capnometry) determinations were obtained at baseline and 15 min after the end of fluid infusion. After fluid challenge, cardiac index (CI) increased from 3.8 (range 2.9–4.2) to 4.2 (range 3.1–4.9) l/min m⁻² (p<0.05). The PCO₂ gap decreased from 9.8 (range 6.9–26.0) to 8.5 (range 6.6–17.4) mm Hg (p<0.05), but important individual variations were observed. We failed to observe significant relationships between changes in CI and in PCO₂ gap, or between indices of preload (pulmonary artery occluded pressure, right atrial pressure, and pulse pressure variations) and changes in PCO₂ gap. In addition, changes in PCO₂ gap and in (v-a) CO₂ were not related; however, changes in PCO₂ gap were related to baseline PCO₂ gap (p=0.003), PEEP (p=0.02), and cumulative doses of vasopressors (p=0.02).

Conclusions

The effects of fluid challenge on gastric mucosal PCO₂ are variable and related to baseline PCO₂ gap rather than to systemic variables. In general, rapid volume infusion decreases PCO₂ gap, but this effect is more pronounced in patients with presumably impaired mucosal perfusion.

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Title: Effects of fluid challenge on gastric mucosal PCO2 in septic patients
Authors: Eliézer Silva
Daniel De Backer
Jacques Creteur
Jean-Louis Vincent
Publication date: 01-03-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-2115-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of fluid challenge on gastric mucosal PCO₂ in septic patients

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

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