Effect of acute moderate changes in PaCO2 on global hemodynamics and gastric perfusion

Mas, Arantxa; Saura, Pilar; Joseph, D.; Blanch, Lluís; Baigorri, F.; Artigas, Antonio; Fernández, Rafael

doi:10.1097/00003246-200002000-00012

Cited by 78 publications

(50 citation statements)

References 28 publications

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“…Hypercapnia increases sympathetic nervous activities which are followed by an increase in cardiac output and peripheral vasodilatation (25)(26)(27)(28). Increases in CBF in both groups were proportional to those in ETCO 2 in the present study.…”

Section: Discussionsupporting

confidence: 60%

Changes in Partial Pressure of Arterial Carbon Dioxide Induces Redistribution of Oral Tissue Blood Flow in the Rabbit

Handa

Ichinohe

Kaneko

2008

Journal of Oral and Maxillofacial Surgery

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Mariko HANDA Changes in PaCO 2 induced redistribution of oral tissue blood flow in the rabbit Eur. J. Oral Sci.The purpose of this study was to investigate the effect of PaCO 2 changes on oral tissue blood flow. Twenty male tracheotomized Japan White rabbits were anesthetized with isoflurane (ISO) or propofol (PROP) under mechanical ventilation. Observed variables included heart rate, blood pressure, common carotid artery blood flow (CBF), tissue blood flow of the mandib ular bone marrow (BBF), of the masseter muscle (MBF), and of the mandibular periosteum (PBF). After completion of the experimental preparation, CO 2 was added to inspired gas to change inspired CO 2 tension. Measurements were performed when end-tidal CO 2 tension (ETCO 2 ) was maintained at 4, 5.3, 6.7 and 8 kPa.Heart rate in both groups gradually decreased as ETCO 2 increased. In contrast, both systolic and diastolic arterial pressures gradually increased as ETCO 2 increased. Both CBF and BBF increased, while MBF decreased as ETCO 2 increased. PBF showed no change throughout the experiment. Positive relationship was observed between CBF and BBF. In contrast, negative relationship was observed between CBF and MBF. These results suggested that changes in PaCO 2 may induce redistribution of oral tissue blood 3 flow during both ISO and PROP anesthesia.

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Section: Discussionsupporting

confidence: 60%

Changes in Partial Pressure of Arterial Carbon Dioxide Induces Redistribution of Oral Tissue Blood Flow in the Rabbit

Handa

Ichinohe

Kaneko

2008

Journal of Oral and Maxillofacial Surgery

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“…Mild hypercapnia increases cardiac index in lean patients (16) and may induce peripheral vasodilation (17). Which factor contributes most to improved PsqO 2 remains unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Mild hypercapnia (i.e., an end-tidal PCO 2 of 50 mmHg) increases cardiac index (16) and may induce peripheral vasodilation (17). Hypercapnia thus significantly increases PsqO 2 in lean volunteers (16) and surgical patients (18), and does so at no cost and with minimal side effects.…”

Section: Introductionmentioning

confidence: 99%

Hypercapnia Improves Tissue Oxygenation in Morbidly Obese Surgical Patients

Hager¹,

Reddy²,

Mandadi³

et al. 2006

Anesthesia & Analgesia

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Risk of wound infection is increased in morbidly obese surgical patients, in part because a major determinant of wound infection risk, tissue oxygenation, is marginal. Unlike in lean patients, supplemental inspired oxygen (FIO 2 ) only slightly improves tissue oxygenation in obese patients. Mild hypercapnia improves tissue oxygenation in lean, but has not been evaluated in obese patients. We thus tested the hypothesis that mild hypercapnia markedly improves tissue oxygenation in morbidly obese patients given FIO 2 80% during major abdominal surgery. Thirty obese patients (body mass index 61.5±17 kg/m 2 ) scheduled for open gastric bypass were randomly assigned to normocapnia (n=15, end-tidal PCO 2 35 mmHg) or hypercapnia (n=15, end-tidal PCO 2 50 mmHg); FIO 2 was 80%. Anesthetic management and other confounding factors were controlled. Tissue oxygen tension was measured subcutaneously at the upper arm using a polarographic probe in a silastic tonometer. Demographic characteristics, cardiovascular measurements, and PaO 2 (222±48 versus 230±68 mmHg in normocapnic versus hypercapnic; mean±SD, P=0.705) were comparable in the groups. Tissue oxygen tension, however, was greater in hypercapnic than in normocapnic patients (78±31 versus 56±13 mmHg, P=0.029). Mild hypercapnia increased tissue oxygenation by

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“…During PRCO measurements, for a given minute ventilation, PaCO 2 usually increases up to 6 mmHg while mixed venous PCO 2 basically remains unchanged. Hemodynamic changes related to acute changes in CO 2 levels are well documented [31]. Consequently, to test whether transient increases in P ET CO 2 could induce a bias in the measurement we measured TDCO immediately before, during, and immediately after the partial rebreathing period.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a noninvasive method for cardiac output measurement in critical care patients

et al. 2002

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Effect of acute moderate changes in PaCO2 on global hemodynamics and gastric perfusion

Abstract: In this small group of stable patients, moderate acute variations in Paco2 had a significant effect on global hemodynamics, but splanchnic perfusion, assessed by deltaPco2, did not change. In these conditions, the use of pHi to evaluate gastric perfusion appears unreliable.

Cited by 78 publications

References 28 publications

Changes in Partial Pressure of Arterial Carbon Dioxide Induces Redistribution of Oral Tissue Blood Flow in the Rabbit

Changes in Partial Pressure of Arterial Carbon Dioxide Induces Redistribution of Oral Tissue Blood Flow in the Rabbit

Hypercapnia Improves Tissue Oxygenation in Morbidly Obese Surgical Patients

Evaluation of a noninvasive method for cardiac output measurement in critical care patients

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