Changes in central venous-to-arterial carbon dioxide tension induced by fluid bolus in critically ill patients.
oleh: Charalampos Pierrakos, David De Bels, Thomas Nguyen, Dimitrios Velissaris, Rachid Attou, Jacques Devriendt, Patrick M Honore, Fabio Silvio Taccone, Daniel De Backer
| Format: | Article |
|---|---|
| Diterbitkan: | Public Library of Science (PLoS) 2021-01-01 |
Deskripsi
<h4>Background</h4>In this prospective observational study, we evaluated the effects of fluid bolus (FB) on venous-to-arterial carbon dioxide tension (PvaCO2) in 42 adult critically ill patients with pre-infusion PvaCO2 > 6 mmHg.<h4>Results</h4>FB caused a decrease in PvaCO2, from 8.7 [7.6-10.9] mmHg to 6.9 [5.8-8.6] mmHg (p < 0.01). PvaCO2 decreased independently of pre-infusion cardiac index and PvaCO2 changes during FB were not correlated with changes in central venous oxygen saturation (ScvO2) whatever pre-infusion CI. Pre-infusion levels of PvaCO2 were inversely correlated with decreases in PvaCO2 during FB and a pre-infusion PvaCO2 value < 7.7 mmHg could exclude a decrease in PvaCO2 during FB (AUC: 0.79, 95%CI 0.64-0.93; Sensitivity, 91%; Specificity, 55%; p < 0.01).<h4>Conclusions</h4>Fluid bolus decreased abnormal PvaCO2 levels independently of pre-infusion CI. Low baseline PvaCO2 values suggest that a positive response to FB is unlikely.