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Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
07:52

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

Published on: January 29, 2011

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[Central venous blood gas analysis]

Marco Marano, Anna D'Amato, Giovanna Guiotto

    Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
    |March 17, 2015
    PubMed

    The hemodialysis might interfere with patients hemodynamic, as the technique allows a sophisticated game with extra and intravascular fluids. As the cardiocirculatory response could sometimes be unpredictable, it is interesting to collect valuable information by reaching a deep understanding of the tissue metabolism which is mirrored by the blood gas analysis of variations in arterial and central venous blood samples. Particularly interesting are the time course variations of the central venous hemoglobin saturation (ScvO2), which are directly related to the patient with O2-demand as well as to the O2-Delivery (DO2). The ScvO2 is determined by four parameters (cardiac output, Hb concentration, arterial Hb saturation and O2 consumption): If the fluids subtraction during dialysis was about to determine an occult hypoperfusion, the ScvO2 reduction would be a timely warning sign to be considered. Moreover, while the normal veno-arterial PCO2 difference is 2-4 mmHg, whenever a mismatch between O2-demand and DO2arise, a larger v-aPCO2 difference should be observed.

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