April 1, 2016MedicineOpen Access

Association Between End-Tidal Carbon Dioxide Pressure and Cardiac Output During Fluid Expansion in Operative Patients Depend on the Change of Oxygen Extraction

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Why the study?

Does variation in EtCO2 during volume expansion predict changes in oxygen extraction in postoperative cardiac surgery patients?

Population

51 adult patients undergoing cardiac surgery admitted to the intensive care unit in whom the physician…

Design

Cohort, Transthoracic echocardiography was performed by a physician who was…

Follow-up

10 minutes after volume expansion

Authors

PGPierre‐Grégoire GuinotApple (Israel)MGMathieu GuilbartCentre Hospitalier Universitaire Amiens-Picardie AHAbdel Hakim HchikatCentre Hospitalier Universitaire Amiens-Picardie

Discussion

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Implication

EtCO2 variation during volume expansion was associated with O2ER changes in post-cardiac surgery ICU patients; leaves open its value for guiding resuscitation.

Structured PICO

Does variation in EtCO2 during volume expansion predict changes in oxygen extraction in postoperative cardiac surgery patients?

Population

51 adult patients undergoing cardiac surgery admitted to the intensive care unit in whom the physician decided to perform volume expansion (indications: arterial hypotension, oliguria, clinical signs of hypoperfusion, arterial hyperlactatemia). Mean age 70, 35 male / 16 female.

Intervention

Volume expansion with 500 mL of lactated Ringer solution over 10 minutes.

Outcome

Correlation between variations in end-tidal carbon dioxide tension (EtCO2) during volume expansion and changes in oxygen extraction (O2ER), and the predictive value of EtCO2 for a >10% decrease in O2ER.surrogate

In postoperative cardiac surgery patients, changes in EtCO2 during volume expansion predict changes in oxygen extraction, serving as a noninvasive indicator of systemic oxygen supply dependency.

Limitations

Study population (patients after heart surgery) may have differed from septic shock patients
Blood gas parameters measured from a central venous catheter and not from a pulmonary artery catheter
Mathematical coupling cannot be ruled out
Method used to calculate alveolar dead space was not standardized
Cannot be extrapolated to EtCO2 changes that result from the administration of vasopressor drugs
Did not measure VCO2

Cite This Study

Guinot et al. (2016) studied this question.

synapsesocial.com/papers/6a76526913be7c199887ffdd https://doi.org/10.1097/md.0000000000003287

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Implication

EtCO2 variation during volume expansion was associated with O2ER changes in post-cardiac surgery ICU patients; leaves open its value for guiding resuscitation.

Association Between End-Tidal Carbon Dioxide Pressure and Cardiac Output During Fluid Expansion in Operative Patients Depend on the Change of Oxygen Extraction

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Association Between End-Tidal Carbon Dioxide Pressure and Cardiac Output During Fluid Expansion in Operative Patients Depend on the Change of Oxygen Extraction

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider