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Journal of Clinical Monitoring and Computing

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01-08-2017 | Original Research

The venous–arterial difference in CO₂ should be interpreted with caution in case of respiratory alkalosis in healthy volunteers

Authors: Jerome Morel, Laurent Gergelé, Alexandre Dominé, Serge Molliex, Jean-Luc Perrot, Bruno Labeille, Frederic Costes

Published in: Journal of Clinical Monitoring and Computing | Issue 4/2017

Abstract

The venous–arterial difference in CO₂ (ΔCO₂) has been proposed as an index of the adequacy of tissue perfusion in shock states. We hypothesized that the variation in PaCO₂ (hyper- or hypocapnia) could impact ΔCO₂, partly through microcirculation adaptations. Fifteen healthy males volunteered to participate. For hypocapnia condition (hCO₂), the subjects were asked to hyperventilate, while they were asked to breathe a gas mixture containing 8 % CO₂ for hypercapnia condition (HCO₂). The 2 conditions were randomly assigned. Blood gases were measured at baseline before each condition, and after 5–7 min of either hCO₂ or HCO₂ condition. Microcirculation was assessed by the muscle reoxygenation slope measured with near infrared spectroscopy following a vascular occlusion test and by skin circulation with in vivo reflectance confocal microscopy. ΔCO₂ was significantly increased with hCO₂ while it tended to decrease with HCO₂ (non-significant). HCO₂ induced a moderate increase of the resaturation slope of NIRS oxygenation. Skin microcirculatory blood flow significantly dropped with hCO₂, while it remained unchanged with hypercapnia. Our results warrant cautious interpretation of ΔCO₂ as an indicator of tissue perfusion during respiratory alkalosis.

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Title: The venous–arterial difference in CO2 should be interpreted with caution in case of respiratory alkalosis in healthy volunteers
Authors: Jerome Morel
Laurent Gergelé
Alexandre Dominé
Serge Molliex
Jean-Luc Perrot
Bruno Labeille
Frederic Costes
Publication date: 01-08-2017
Publisher: Springer Netherlands
Published in: Journal of Clinical Monitoring and Computing / Issue 4/2017
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-016-9897-6

At a glance: The STEP trials

Springer Medicine

The venous–arterial difference in CO₂ should be interpreted with caution in case of respiratory alkalosis in healthy volunteers

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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