Looking for CO
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            : Exploring the Novel Finding of Low Respiratory Quotient After Cardiac Arrest

Berg, Katherine M.; Donnino, Michael W.; Callaway, Clifton W.

doi:10.1161/jaha.118.009500

Cited by 3 publications

(2 citation statements)

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“…This area of research has been limited by the difficulty of measuring VO 2 reliably and accurately in the critically ill (11,12). In earlier studies, VO 2 was either calculated, which required placement of a pulmonary artery catheter, or measured by indirect calorimetry, using large and somewhat cumbersome equipment that is not available in many intensive care units (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Hoeyer-Nielsen

Holmberg

Grossestreuer

et al. 2020

Shock

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Introduction: Mitochondrial dysfunction leading to impairment of oxygen extraction, referred to as cytopathic hypoxia, contributes to morbidity in sepsis. Oxygen consumption (VO 2 ) may be a useful measure of the severity of cytopathic hypoxia. We monitored VO 2 and carbon dioxide production (VCO 2 ) in septic patients and investigated the association with hospital survival. Methods: We retrospectively identified adult (!18 years) septic patients from a larger prospective observational cohort of critically ill patients on mechanical ventilation. A gas-exchange monitor recorded continuous VO 2 and VCO 2 for up to 48 h. We then tested the association of median VO 2 , VCO 2 , respiratory quotient (RQ), and the VO 2 :lactate ratio with survival. Results: A total of 46 septic patients were included in the analysis, of whom 28 (61%) survived. Overall median VO 2 was not associated with survival (3.72 mL/kg/min [IQR: 3.39, 4.92] in survivors and 3.42 mL/ kg/min [IQR: 2.97, 5.26] in non-survivors, P ¼ 0.12). The overall median VCO 2 and RQ were also not associated with survival. Adjusting for age and the presence of shock did not change these results. The VO 2 :lactate ratio was associated with survival (adjusted OR 2.17 [95% CI 1.12, 4.22] per unit increase in ratio, P ¼ 0.03). The percent change in median VCO 2 was 11.6% [IQR: À8.2, 28.7] in survivors compared with À8.3% [IQR: À18.0, 4.7] in non-survivors (P ¼ 0.03). The percent changes in median VO 2 and RQ were not different between groups. Conclusion: The VO 2 :lactate ratio was significantly higher in survivors, while there was no association between median VO 2 alone and survival. There was a significant difference in change in VCO 2 over time between survivors and non-survivors.

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Section: Introductionmentioning

confidence: 99%

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Hoeyer-Nielsen

Holmberg

Grossestreuer

et al. 2020

Shock

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“…A preliminary study using a subgroup of resuscitated cardiac arrest patients from the same cohort as in the present study also demonstrated low RQ values (11). These findings add new insight about cellular metabolism after resuscitation, since RQ values listed outside the usual range (between 0.7 and 1.0 depending on the energy expenditure) have been considered outliers or artifactual errors in some past work (12,29).…”

Section: Discussionmentioning

confidence: 91%

Oxygen Consumption as an Early Warning System in the Critically Ill

Hoeyer-Nielsen,

Holmberg,

Grossestreuer

et al. 2023

Shock

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Introduction In this study, we assessed whether changes in oxygen consumption (VO2) and other metabolic parameters could be used as an early warning system for detecting clinical deterioration in mechanically ventilated patients. Methods This was a prospective cohort study of adult patients requiring mechanical ventilation between February 2016 and March 2019. We looked for changes in VO2, carbon dioxide production (VCO2), respiratory quotient (RQ), and end-tidal carbon dioxide (EtCO2), occurring prior to clinical deterioration. Clinical deterioration was pre-defined as a requirement of vasopressor, an increase in serum lactate by 20% where at least one value was above 3 mmol/L, or a decrease in hemoglobin by 20% in the four hours prior to clinical deterioration. Results A total of 141 patients were included. There were no detectable changes in VO2, VCO2, and EtCO2 within the four hours prior to any clinical deterioration. RQ increased significantly within the four hours prior to an increase in lactate as compared to no increase in lactate but there were no detectable changes prior to other clinical deteriorations. Conclusions RQ has the potential to be an early marker of tissue hypoperfusion or mitochondrial dysfunction. However, future studies are necessary to evaluate the use of RQ as a bedside monitor in critical care settings.

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Low oxygen in inspired air causes severe cerebrocortical hypoxia and cell death in the cerebral cortex of awake rats

Barakat,

Turcani,

Al-Khaledi

et al. 2024

Neuroscience Letters

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Looking for CO ₂ : Exploring the Novel Finding of Low Respiratory Quotient After Cardiac Arrest

Cited by 3 publications

References 21 publications

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Oxygen Consumption as an Early Warning System in the Critically Ill

Low oxygen in inspired air causes severe cerebrocortical hypoxia and cell death in the cerebral cortex of awake rats

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Looking for CO 2 : Exploring the Novel Finding of Low Respiratory Quotient After Cardiac Arrest

Cited by 3 publications

References 21 publications

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Association Between the Oxygen Consumption: Lactate Ratio and Survival in Critically Ill Patients With Sepsis

Oxygen Consumption as an Early Warning System in the Critically Ill

Low oxygen in inspired air causes severe cerebrocortical hypoxia and cell death in the cerebral cortex of awake rats

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Product

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Looking for CO ₂ : Exploring the Novel Finding of Low Respiratory Quotient After Cardiac Arrest