Arteriovenous differences in PCO2 and cardiac output during CPR in the dog

Sato, Shigehito; Okubo, Naomitsu; Satsumae, Tsuyoshi; Kumagai, Megumi; Yamamoto, Shigeyuki; Nakayama, Harumi; Taguchi, Noriko

doi:10.1016/0300-9572(94)90039-6

Cited by 14 publications

(6 citation statements)

References 15 publications

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“…Similar findings were reported by Oropello et al [4] in an animal model of hemorrhagic shock. Both human and animal models have demonstrated that during cardiopulmonary resuscitation with low pulmonary blood flow, there is an increase in the venous to arterial pCO 2 gradient due to inadequate pulmonary blood flow and CO 2 excretion [5–7]. These data are supported by our current study, which demonstrated an increasing pH and pCO 2 gradient with a declining central venous oxygen saturation suggestive of decreasing cardiac output.…”

Section: Discussionsupporting

confidence: 84%

Correlation of Venous and Arterial Blood Gas Values Following Cardiothoracic Surgery in Infants and Children

McBride

Berkenbosch

Tobias

2001

J Intensive Care Med

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Intermittent measurement of arterial blood gases is and arterial blood gas values following cardiothoracic surgery commonly performed to assess the adequacy of in infants and children. J Intensive Care Med 2001;16:231-235. oxygenation and ventilation. Although noninvasiveThe authors retrospectively compared the correlation of pH monitors are available to assess oxygenation (pulse and pCO 2 from venous and arterial blood gases following oximetry) and ventilation (end-tidal or transcutanecardiothoracic surgery in neonates, infants, and children. ous CO 2 techniques), intermittent correlation withThe cohort for the study included 14 infants and children in vivo values is necessary to ensure the accuracy undergoing cardiovascular surgery procedures for correction of congenital heart disease. The patients ranged in age from of noninvasive devices. In addition, measurement neonates to 48 months (6.2 ‫ע‬ 12.3 months) and in weight of pH and acid/base status may be required to from 2.9 to 16.1 kg (5.0 ‫ע‬ 3.2 kg). A total of 95 simultaneous assess the adequacy of tissue perfusion and gauge samples of arterial and venous blood were obtained for blood the response to ongoing therapies. gas analysis. The mean venous pCO 2 value was 45 ‫ע‬ 9 From the Departments of *Child Health and †Anesthesiology, ‡Division of Pediatric Critical Care/Pediatric Anesthesiology, underwent cardiothoracic surgical procedures were University of Missouri, Columbia, MO.reviewed. In these patients, simultaneous values of

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Section: Discussionsupporting

confidence: 84%

Correlation of Venous and Arterial Blood Gas Values Following Cardiothoracic Surgery in Infants and Children

McBride

Berkenbosch

Tobias

2001

J Intensive Care Med

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“…Multiple factors may have contributed to the decreased effectiveness of epinephrine administration through the HIO route in the hypovolemic pediatric CA porcine model. Low flow state in bone marrow is associated with CA and CPR (approximately 25% of normal), and hypovolemia has also been reported to decrease blood flow significantly thus impairing bone marrow blood flow 32 33. Bone marrow blood flow is responsive to physiological stresses as well as humeral and neurogenic stimuli.…”

Section: Discussionmentioning

confidence: 99%

Effects of humeral intraosseous epinephrine in a pediatric hypovolemic cardiac arrest porcine model

Neill¹,

Burgert

Blouin

et al. 2020

Trauma Surg Acute Care Open

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BackgroundAims of the study were to determine the effects of humerus intraosseous (HIO) versus intravenous (IV) administration of epinephrine in a hypovolemic, pediatric pig model. We compared concentration maximum (Cmax), time to maximum concentration (Tmax), mean concentration (MC) over time and return of spontaneous circulation (ROSC).MethodsPediatric pig were randomly assigned to each group (HIO (n=7); IV (n=7); cardiopulmonary resuscitation (CPR)+defibrillation (defib) (n=7) and CPR-only group (n=5)). The pig were anesthetized; 35% of the blood volume was exsanguinated. pigs were in arrest for 2 min, and then CPR was performed for 2 min. Epinephrine 0.01 mg/kg was administered 4 min postarrest by either route. Samples were collected over 5 min. After sample collection, epinephrine was administered every 4 min or until ROSC. The Cmax and MC were analyzed using high-performance liquid chromatography. Defibrillation began at 3 min postarrest and administered every 2 min or until ROSC or endpoint at 20 min after initiation of CPR.ResultsAnalysis indicated that the Cmax was significantly higher in the IV versus HIO group (p=0.001). Tmax was shorter in the IV group but was not significantly different (p=0.789). The MC was significantly greater in the IV versus HIO groups at 90 and 120 s (p<0.05). The IV versus HIO had a significantly higher MC (p=0.001). χ2 indicated the IV group (5 out of 7) had significantly higher rate of ROSC than the HIO group (1 out of 7) (p=0.031). One subject in the CPR+defib and no subjects in the CPR-only groups achieved ROSC.DiscussionBased on the results of our study, the IV route is more effective than the HIO route.

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“…Se postula que la hipercapnia venosa ocurriría al ser tamponados los hidrogeniones producidos por el metabolismo anaerobio, para mantener el equilibrio ácido-base en células con un potencial redox disminuido. Así como la pCO 2 arterial depende de la ventilación alveolar y del intercambio gaseoso pulmonar, la pCO 2 venosa depende del flujo circulatorio y no necesariamente de la hipoxia hipoxémica, correlacionándose inversamente al GC en falla circulatoria 14,[21][22][23][24][25][26][27][28][29][30] , hallazgo reafirmado en este modelo pediátrico. Concordantemente se ha propuesto un rol de la ΔVACO 2 en guiar la terapia de reanimación, de manera complementaria a la saturación venosa central de oxígeno 13 .…”

Section: Discussionunclassified

Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

et al. 2012

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Arteriovenous differences in PCO2 and cardiac output during CPR in the dog

Cited by 14 publications

References 15 publications

Correlation of Venous and Arterial Blood Gas Values Following Cardiothoracic Surgery in Infants and Children

Correlation of Venous and Arterial Blood Gas Values Following Cardiothoracic Surgery in Infants and Children

Effects of humeral intraosseous epinephrine in a pediatric hypovolemic cardiac arrest porcine model

Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

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