Top

Journal of Clinical Monitoring and Computing

Published in:

01-12-2017 | Letter to the Editor

Understanding elevated Pv-aCO₂ gap and Pv-aCO₂/Ca-vO₂ ratio in venous hyperoxia condition

Authors: Huai-wu He, Da-wei Liu, Can Ince

Published in: Journal of Clinical Monitoring and Computing | Issue 6/2017

Excerpt

We read with interest the recently published paper by Saludes and co-workers about the effect of venous hyperoxia on central venous-to-arterial carbon dioxide difference during a 5 min oxygen challenge test (OCT) in J Clin Monit Comput [1]. The authors found that the Pv-aCO₂ gap and Pv-aCO₂/Ca-vO₂ ratio significantly increased after the 5 min inspiration of 1.0 FiO₂, and concluded that the resultant elevated Pv-aCO₂ gap and Pv-aCO₂/Ca-vO₂ ratio might be caused by venous hyperoxia but not from changes in blood flow. However, we believe that this conclusion should be taken with caution. There are several other issues which could be taken into consideration when explaining the elevated Pv-aCO₂ gap and Pv-aCO₂/Ca-vO₂ ratio following hyperoxia during OCT. …

Saludes P, Proença L, Gruartmoner G, Enseñat L, Pérez-Madrigal A, Espinal C, Mesquida J. Central venous-to-arterial carbon dioxide difference and the effect of venous hyperoxia: a limiting factor, or an additional marker of severity in shock? J Clin Monit Comput. 2016: 1–9.

He HW, Liu DW, Long Y, Wang XT. Mind the influence of arterial oxygen tension on central venous oxygen saturation. Crit Care. 2014;18(5):569.

Ho KM, Harding R, Chamberlain J. The impact of arterial oxygen tension on venous oxygen saturation in circulatory failure. Shock. 2008;29:3–6.PubMed

Reinhart K, Bloos F, Konig F, et al. Reversible decrease of oxygen consumption by hyperoxia. Chest. 1991;99:690–94.CrossRefPubMed

Barth E, Bassi G, Maybauer DM, Simon F, et al. Effects of ventilation with 100% oxygen during early hyperdynamic porcine fecal peritonitis. Crit Care Med. 2008;36:495–503.CrossRefPubMed

Dres M, Monnet X, Teboul JL. Hemodynamic management of cardiovascular failure by using PCO(2) venous-arterial difference. J Clin Monit Comput. 2012;26(5):367–74.CrossRefPubMed

Ospina-Tascon GA, Umana M, Bermudez WF, Bautista-Rincon DF, Valencia JD, Madrinan HJ, Hernandez G, Bruhn A, Arango-Davila C, De Backer D. Can venous-to-arterial carbon dioxide differences reflect microcirculatory alterations in patients with septic shock? Intensive Care Med. 2016;42:211–21.CrossRefPubMed

Mallat J, Lemyze M, Tronchon L, Vallet B, Thevenin D. Use of venous-to-arterial carbon dioxide tension difference to guide resuscitation therapy in septic shock. World J Crit Care Med. 2016;5(1):47–56.CrossRefPubMedPubMedCentral

Orbegozo Cortés D, Puflea F, Donadello K, Taccone FS, Gottin L, Creteur J, Vincent JL, De Backer D. Normobaric hyperoxia alters the microcirculation in healthy volunteers. Microvasc Res. 2015 Mar;98:23–8.CrossRefPubMed

10.

Teboul JL, Scheeren T. Understanding the Haldane effect. Intensive Care Med. 2017;43(1):91–3.CrossRefPubMed

11.

He HW, Liu DW. Central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio: An experimental model or a bedside clinical tool? J Crit Care. 2016;35:219-.CrossRefPubMed

12.

Mesquida J, Saludes P, Gruartmoner G, Espinal C, Torrents E, Baigorri F, Artigas A. Central venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference is associated with lactate evolution in the hemodynamic resuscitation process in early septic shock. Crit Care. 2015;19(1):126.CrossRefPubMedPubMedCentral

13.

Monnet X, Julien F, Ait-Hamou N, et al. lactate and venoarterial carbon dioxide difference/arterial-venous oxygen difference ratio, but not central venous oxygen saturation, predict increase in oxygen consumption in fluid responders. Crit Care Med. 2013;41:1412–20.CrossRefPubMed

14.

He HW, Liu DW, Long Y, Wang XT. High central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio is associated with poor lactate clearance in septic patients after resuscitation. J Crit Care. 2016;31(1):76–81.CrossRefPubMed

Title: Understanding elevated Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio in venous hyperoxia condition
Authors: Huai-wu He
Da-wei Liu
Can Ince
Publication date: 01-12-2017
Publisher: Springer Netherlands
Published in: Journal of Clinical Monitoring and Computing / Issue 6/2017
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-017-0005-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Understanding elevated Pv-aCO₂ gap and Pv-aCO₂/Ca-vO₂ ratio in venous hyperoxia condition

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 6/2017

The influence of PEEP and positioning on central venous pressure and venous hepatic hemodynamics in patients undergoing liver resection

Continuous blood pressure monitoring via non-invasive radial artery applanation tonometry and invasive arterial catheter demonstrates good agreement in patients undergoing colon carcinoma surgery

Estimation of breathing rate in thermal imaging videos: a pilot study on healthy human subjects

Influence of continuously evolving transcatheter aortic valve implantation technology on cerebral oxygenation

Applicability of stroke volume variation in patients of a general intensive care unit: a longitudinal observational study

The visualization of glottis during intubation’s efforts in super obese patients: a comparison of total track video intubating laryngeal mask and McGrath MAC videolaryngoscope