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Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia
Despite blood transfusions are administered to restore adequate tissue oxygenation, transfusion guidelines consider only hemoglobin as trigger value, which gives little information about the balance between oxygen delivery and consumption. Central venous oxygen saturation is an alternative, however...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138121/ https://www.ncbi.nlm.nih.gov/pubmed/25137377 http://dx.doi.org/10.1371/journal.pone.0105148 |
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author | Kocsi, Szilvia Demeter, Gábor Érces, Dániel Kaszaki, József Molnár, Zsolt |
author_facet | Kocsi, Szilvia Demeter, Gábor Érces, Dániel Kaszaki, József Molnár, Zsolt |
author_sort | Kocsi, Szilvia |
collection | PubMed |
description | Despite blood transfusions are administered to restore adequate tissue oxygenation, transfusion guidelines consider only hemoglobin as trigger value, which gives little information about the balance between oxygen delivery and consumption. Central venous oxygen saturation is an alternative, however its changes reflect systemic metabolism and fail to detect regional hypoxia. A complementary parameter to ScvO(2) may be central venous-to-arterial carbon dioxide difference (CO(2)-gap). Our aim was to investigate the change of alternative transfusion trigger values in experimental isovolemic anemia. After splenectomy, anesthetized Vietnamese mini pigs (n = 13, weight range: 18–30 kg) underwent controlled bleeding in five stages (T(1)–T(5)). During each stage approximately 10% of the estimated starting total blood volume was removed and immediately replaced with an equal volume of colloid. Hemodynamic measurements and blood gas analysis were then performed. Each stage of bleeding resulted in a significant fall in hemoglobin, the O(2)-extraction increased significantly from T(3) and ScvO(2) showed a similar pattern and dropped below the physiological threshold of 70% at T(4). By T(4) CO(2)-gap increased significantly and well correlated with VO(2)/DO(2) and ScvO(2). To our knowledge, this is the first study to show that anemia caused altered oxygen extraction may have an effect on CO(2)-gap. |
format | Online Article Text |
id | pubmed-4138121 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-41381212014-08-20 Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia Kocsi, Szilvia Demeter, Gábor Érces, Dániel Kaszaki, József Molnár, Zsolt PLoS One Research Article Despite blood transfusions are administered to restore adequate tissue oxygenation, transfusion guidelines consider only hemoglobin as trigger value, which gives little information about the balance between oxygen delivery and consumption. Central venous oxygen saturation is an alternative, however its changes reflect systemic metabolism and fail to detect regional hypoxia. A complementary parameter to ScvO(2) may be central venous-to-arterial carbon dioxide difference (CO(2)-gap). Our aim was to investigate the change of alternative transfusion trigger values in experimental isovolemic anemia. After splenectomy, anesthetized Vietnamese mini pigs (n = 13, weight range: 18–30 kg) underwent controlled bleeding in five stages (T(1)–T(5)). During each stage approximately 10% of the estimated starting total blood volume was removed and immediately replaced with an equal volume of colloid. Hemodynamic measurements and blood gas analysis were then performed. Each stage of bleeding resulted in a significant fall in hemoglobin, the O(2)-extraction increased significantly from T(3) and ScvO(2) showed a similar pattern and dropped below the physiological threshold of 70% at T(4). By T(4) CO(2)-gap increased significantly and well correlated with VO(2)/DO(2) and ScvO(2). To our knowledge, this is the first study to show that anemia caused altered oxygen extraction may have an effect on CO(2)-gap. Public Library of Science 2014-08-19 /pmc/articles/PMC4138121/ /pubmed/25137377 http://dx.doi.org/10.1371/journal.pone.0105148 Text en © 2014 Kocsi et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Kocsi, Szilvia Demeter, Gábor Érces, Dániel Kaszaki, József Molnár, Zsolt Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia |
title | Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia |
title_full | Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia |
title_fullStr | Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia |
title_full_unstemmed | Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia |
title_short | Central Venous-To-Arterial CO(2)-Gap May Increase in Severe Isovolemic Anemia |
title_sort | central venous-to-arterial co(2)-gap may increase in severe isovolemic anemia |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138121/ https://www.ncbi.nlm.nih.gov/pubmed/25137377 http://dx.doi.org/10.1371/journal.pone.0105148 |
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