Mismatch of arterial and central venous blood gas analysis during haemorrhage.

Détails

ID Serval
serval:BIB_A1C681E5B692
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Mismatch of arterial and central venous blood gas analysis during haemorrhage.
Périodique
European Journal of Anaesthesiology
Auteur(s)
Theusinger Oliver M., Thyes Caroline, Frascarolo Philippe, Schramm Sebastian, Seifert Burkhardt, Spahn Donat R.
ISSN
1365-2346[electronic], 0265-0215[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
27
Numéro
10
Pages
890-896
Langue
anglais
Résumé
BACKGROUND AND OBJECTIVE: Arterial base excess and lactate levels are key parameters in the assessment of critically ill patients. The use of venous blood gas analysis may be of clinical interest when no arterial blood is available initially.
METHODS: Twenty-four pigs underwent progressive normovolaemic haemodilution and subsequent progressive haemorrhage until the death of the animal. Base excess and lactate levels were determined from arterial and central venous blood after each step. In addition, base excess was calculated by the Van Slyke equation modified by Zander (BE(z)). Continuous variables were summarized as mean +/- SD and represent all measurements (n = 195).
RESULTS: Base excess according to National Committee for Clinical Laboratory Standards for arterial blood was 2.27 +/- 4.12 versus 2.48 +/- 4.33 mmol(-l) for central venous blood (P = 0.099) with a strong correlation (r(2) = 0.960, P < 0.001). Standard deviation of the differences between these parameters (SD-DIFBE) did not increase (P = 0.355) during haemorrhage as compared with haemodilution. Arterial lactate was 2.66 +/- 3.23 versus 2.71 +/- 2.80 mmol(-l) in central venous blood (P = 0.330) with a strong correlation (r(2) = 0.983, P < 0.001). SD-DIFLAC increased (P < 0.001) during haemorrhage. BE(z) for central venous blood was 2.22 +/- 4.62 mmol(-l) (P = 0.006 versus arterial base excess according to National Committee for Clinical Laboratory Standards) with strong correlation (r(2) = 0.942, P < 0.001). SD-DIFBE(z)/base excess increased (P < 0.024) during haemorrhage.
CONCLUSION: Central venous blood gas analysis is a good predictor for base excess and lactate in arterial blood in steady-state conditions. However, the variation between arterial and central venous lactate increases during haemorrhage. The modification of the Van Slyke equation by Zander did not improve the agreement between central venous and arterial base excess.
Mots-clé
blood gas analysis, haemorrhagic shock, lactate, severe acidosis, multiple organ failure, base deficit, lactate levels, trauma patients, oxygen utilization, intensive-care, septic shock, excess, resuscitation, mortality
Pubmed
Web of science
Création de la notice
30/09/2010 14:54
Dernière modification de la notice
20/08/2019 16:07
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