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Urinary PCO2 for hemodynamically unstable patients

M S Lin1, T C Lien, W C Yang

  • 1Department of Respiratory Therapy, Veterans General Hospital-Taipei, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|February 1, 1996
PubMed
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Urinary PCO2 effectively differentiates hemodynamically unstable patients from stable ones. This novel method shows promise for assessing perfusion adequacy in critically ill individuals.

Area of Science:

  • Critical care medicine
  • Renal physiology
  • Hemodynamic monitoring

Background:

  • Gastric intramural pH (pHi) assesses splanchnic ischemia but has limitations.
  • Urinary bladder is an accessible alternative for monitoring.
  • Urinary PCO2 has not been studied for perfusion adequacy in critically ill patients.

Purpose of the Study:

  • To evaluate urinary PCO2 as a marker for hemodynamic instability.
  • To assess the correlation between urinary PCO2 and hemodynamic parameters.

Main Methods:

  • Fifty intensive care unit patients were divided into stable and unstable hemodynamic groups.
  • Measured parameters included arterial pressure, dopamine dosage, heart rate, serum lactate, arterial blood gas, urinary PCO2, and urine electrolytes.

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  • Excluded patients with renal or pre-renal conditions affecting urinary PCO2.

    • Main Results:

    • Urinary PCO2 was significantly higher in hemodynamically unstable patients (78.6 vs. 43.1 mmHg).
    • Unstable patients had higher serum anion gap, dopamine dosage, and heart rate, with lower PaO2/FiO2 ratio and mean arterial pressure.
    • Urinary PCO2 correlated significantly with dopamine dosage in unstable patients.

    Conclusions:

    • Urinary PCO2 can effectively differentiate hemodynamically unstable from stable patients.
    • Urinary PCO2 is a potential non-invasive marker for assessing perfusion adequacy.
    • Urinary PCO2 shows significant correlation with dopamine dosage in unstable patients.