Oxygen consumption, carbon dioxide production and lactic acid during                 normothermic cardiopulmonary bypass

Engoren, Milo; Evans, Michael A.

doi:10.1177/026765910001500506

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…CPB has previously been shown to be associated with lactic acidosis and attributed to poor peripheral perfusion; however, higher CPB pump flows may prevent this. 16 Higher intraoperative lactic acid levels were significantly associated with higher first ICU and peak ICU lactic acid levels (Table 2). Additionally, use of nitric oxide and higher PAPs were associated with lower lactic acid levels in the ICU.…”

Section: Commentmentioning

confidence: 98%

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Worrell

Haug

Dubovoy

et al. 2020

The Annals of Thoracic Surgery

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Background. Elevated lactate levels may be caused by increased production suggestive of tissue ischemia; however, they may also occur without evidence of ischemia, by catecholamine activation of beta receptors. The purpose of this study was to determine the factors associated with increased lactate levels during and after lung transplantation and to evaluate whether lactate levels were associated with increased time to extubation and postoperative complications.Methods. This was a retrospective study of patients who underwent lung transplantation between January 2015 and May 2017 at the University of Michigan, Ann Arbor, MI. Multivariable linear regression was used to determine the factors associated with peak lactate levels and to find the associations between lactate levels and outcomes of nitric oxide time, intubation time, length of stay, and creatinine level. Logistic regression was used to determine the associations between lactate levels and acute kidney injury and atrial fibrillation.Results. A total of 86 patients underwent singlelung transplantation (n [ 17; 20%

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Section: Commentmentioning

confidence: 98%

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Worrell

Haug

Dubovoy

et al. 2020

The Annals of Thoracic Surgery

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“…In a similar study, Engoren et al reviewed 20 patients under the cardiopulmonary bypass, the levels of lactic acid, oxygenated (VO2) and produced carbon dioxide (VCO 2 ) were measured. 19 According to the results of this study, the levels of lactate were not correlated with the levels of oxygen and carbon dioxide measured . This is a different result of our study, perhaps the reason for this difference due to sample size, type of surgery and the time of measurement of variables.…”

Section: Discussionmentioning

confidence: 56%

The relationship between serum lactate and VO2/VCO2 in patients undergoing coronary artery bypass grafting in Ardabil city hospital, 2017

2018

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Background: VO2/VCO2 ratio and blood lactate are different indices of adequacy of oxygen delivery to oxygen needs. The aim of this study was to investigate the relationship between serum lactate and VO2/VCO2 in patients undergoing CABG in Ardabil city.Methods: This descriptive-analytical study was performed on 30 patients who underwent CABG at Ardabil city hospital during 2017. Demographic data of patients including age and sex were collected. Standard monitoring included electrocardiogram, invasive arterial pressure, pulse oximetry, end tidal carbon dioxide, temperature and urine output was done. The CAB was carried out through a CPB pump at the time of grafting. Blood lactate and VO2/VCO2 were measured in 3 groups of patients based on number of grafts, EF and serum Creatinine. Collected data analyzed by statistical methods in SPSS version 19. Results: Most of patients were male (86.7%). The mean age of patients was 58.1 years. The blood lactate and VO2/VCO2 values increased after surgery. There was no statistically significant difference in two groups based on number of grafts and serum Cr but it was statistically significant based on E/F. There was a significant correlation between Blood lactate and VO2/VCO2 ratio in patients.Conclusions: The results showed that blood lactate as an indicator for patients status during CABG surgery can be replaced with VO2/VCO2.

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“…Although some workers have used VCO 2 as predicted by the Fick's principle, 7,8 we are unaware of any studies using oxygenator exhaust capnography nor of any that compare the two techniques or relate these methods to VO 2 . The aim of this study was to compare the agreement between VCO 2 as predicted by Fick's principle with that estimated by oxygenator exhaust CO 2 output, and to compare both methods of VCO 2 estimation with VO 2 as predicted by Fick's principle.…”

Section: Introductionmentioning

confidence: 99%

Measurement of systemic carbon dioxide production during cardiopulmonary bypass: a comparison of Fick’s principle with oxygentor exhaust output

2003

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Theoretically, systemic carbon dioxide (VCO2) production should be an alternative means to systemic oxygen uptake (VO2) for estimating the global efficacy of cardiopulmonary bypass (CPB). This study compared two methods of estimating VCO2: Fick's principle and oxygenator exhaust carbon dioxide (CO2) output. Both of these estimates were then compared with VO2. Fifty-one patients (39 male and 12 female) undergoing elective cardiac surgery requiring CPB were studied. Blood sampling was performed and measurements recorded during active cooling, environmental cooling/stable hypothermia and during rewarming. Blood samples were measured for CO2 tension from which content was estimated. VCO2 was calculated as the product of the arteriovenous difference in CO2 content and pump flow rate (Fick's principle), or the fresh gas flow rate and concentration of the oxygenator exhaust CO2 (output technique). Over all measurements, method comparison analysis revealed a large mean bias of 41 (95% confidence intervals (CI) 32-50) mL/min with very wide limits of agreement (-23, 105 mL/min). Regression analysis found that the bias was also proportional to the size of measurement (beta = 0.75 (95% CI 0.55, 0.95)). Although both methods of VCO2 correlated significantly with VO2 (p < 0.01), regression analysis found that the coefficients (beta) of both techniques had wide CI (Fick's principle: beta = 1.37 (95% CI 1.20, 1.54); output technique: beta = 0.58 (95%CI 0.44, 0.71)). In conclusion, both techniques of VCO2 cannot be used interchangeably, and both are imprecisely related to VO2 as estimated by Fick's principle.

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Oxygen consumption, carbon dioxide production and lactic acid during normothermic cardiopulmonary bypass

Cited by 4 publications

References 22 publications

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

The relationship between serum lactate and VO2/VCO2 in patients undergoing coronary artery bypass grafting in Ardabil city hospital, 2017

Measurement of systemic carbon dioxide production during cardiopulmonary bypass: a comparison of Fick’s principle with oxygentor exhaust output

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