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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2017

Open Access 01-12-2017 | Research

Acute hyperventilation increases the central venous-to-arterial PCO2 difference in stable septic shock patients

Authors: Jihad Mallat, Usman Mohammad, Malcolm Lemyze, Mehdi Meddour, Marie Jonard, Florent Pepy, Gaelle Gasan, Stephanie Barrailler, Johanna Temime, Nicolas Vangrunderbeeck, Laurent Tronchon, Didier Thevenin

Published in: Annals of Intensive Care | Issue 1/2017

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Abstract

Background

To evaluate the effects of acute hyperventilation on the central venous-to-arterial carbon dioxide tension difference (∆PCO2) in hemodynamically stable septic shock patients.

Methods

Eighteen mechanically ventilated septic shock patients were prospectively included in the study. We measured cardiac index (CI), ∆PCO2, oxygen consumption (VO2), central venous oxygen saturation (ScvO2), and blood gas parameters, before and 30 min after an increase in alveolar ventilation (increased respiratory rate by 10 breaths/min).

Results

Arterial pH increased significantly (from 7.35 ± 0.07 to 7.42 ± 0.09, p < 0.001) and arterial carbon dioxide tension decreased significantly (from 44.5 [41–48] to 34 [30–38] mmHg, p < 0.001) when respiratory rate was increased. A statistically significant increase in VO2 (from 93 [76–105] to 112 [95–134] mL/min/m2, p = 0.002) was observed in parallel with the increase in alveolar ventilation. While CI remained unchanged, acute hyperventilation led to a significant increase in ∆PCO2 (from 4.7 ± 1.0 to 7.0 ± 2.6 mmHg, p < 0.001) and a significant decrease in ScvO2 (from 73 ± 6 to 67 ± 8%, p < 0.001). A good correlation was found between changes in arterial pH and changes in VO2 (r = 0.67, p = 0.002). Interestingly, we found a strong association between the increase in VO2 and the increase in ∆PCO2 (r = 0.70, p = 0.001).

Conclusions

Acute hyperventilation provoked a significant increase in ∆PCO2, which was the result of a significant increase in VO2 induced by hyperventilation. The clinician should be aware of the effects of acute elevation of alveolar ventilation on ∆PCO2.
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Metadata
Title
Acute hyperventilation increases the central venous-to-arterial PCO2 difference in stable septic shock patients
Authors
Jihad Mallat
Usman Mohammad
Malcolm Lemyze
Mehdi Meddour
Marie Jonard
Florent Pepy
Gaelle Gasan
Stephanie Barrailler
Johanna Temime
Nicolas Vangrunderbeeck
Laurent Tronchon
Didier Thevenin
Publication date
01-12-2017
Publisher
Springer Paris
Published in
Annals of Intensive Care / Issue 1/2017
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-017-0258-5

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