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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...

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Autores principales: Kocsi, Szilvia, Demeter, Gábor, Érces, Dániel, Kaszaki, József, Molnár, Zsolt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
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.
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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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