Comparison of CO2 rebreathing and acetylene methods for cardiac output

1965 ◽  
Vol 20 (4) ◽  
pp. 763-766 ◽  
Author(s):  
K. Klausen

The cardiac output during rest and work was determined by a CO2 rebreathing method as suggested by Defares. The partial pressure of CO2 in the mixed venous blood (PvCOCO2) was calculated from the rise of the CO2 percent in a Grollman bag during rebreathing. In the rest experiments the partial pressure of CO2 in arterial blood (PaCOCO2) was obtained from analysis of alveolar samples taken by the Haldane-Priestley direct sampling method. In the work experiments the PaCOCO2 was calculated using the Bohr formula and a dead space estimated from Asmussen and Nielsen's data. The metabolic rate including both O2 uptake and CO2 output was determined by the Douglas bag method. In each experiment the acetylene method as described by Christensen was applied after the CO2 rebreathing method. The values obtained by the two methods were almost identical, the standard deviation for all experiments being ±7.3%, and were of the same magnitude as those obtained by others with the dye-dilution or direct Fick method both during rest and work. cardiac output at rest and work; arterial Pco2 and venous Pco2 at rest and work; stroke volume at rest and work Submitted on November 25, 1964

1985 ◽  
Vol 58 (4) ◽  
pp. 1372-1377 ◽  
Author(s):  
M. D. Inman ◽  
R. L. Hughson ◽  
N. L. Jones

Cardiac output (Q) was estimated in supine rest and in upright cycling at several work rates up to 200 W in five male and one female subjects. At least four repetitions of both the CO2-rebreathing plateau method (Collier, J. Appl. Physiol. 9:25–29, 1956) and the Kim et al. (J. Appl. Physiol. 21: 1338–1344, 1966) single-breath method were performed at each work rate, in a steady state of O2 consumption and heart rate. At supine rest and low work rates, estimates of Q were similar by the two methods. However, at higher work rates, the single-breath method significantly (P less than 0.05) underestimated the value obtained by CO2 rebreathing. The reason for the difference in estimates of Q by the two methods was traced to the determination of arterial partial pressure of CO2 (PaCO2) and mixed venous partial pressure of CO2 (PvCO2). The estimate of PaCO2 from the single-breath method was approximately 88.5% of the estimate from end-tidal PCO2 used with the rebreathing method (P less than 0.001). The oxygenated PvCO2 calculated from the single-breath Q averaged approximately 92.5% of the PvCO2 from CO2 rebreathing (P less than 0.0001). The difference in estimates of Q was not eliminated by using a logarithmic form of the CO2 dissociation curve with the single-breath method.


2004 ◽  
Vol 96 (2) ◽  
pp. 428-437 ◽  
Author(s):  
Gabriel Laszlo

The measurement of cardiac output was first proposed by Fick, who published his equation in 1870. Fick's calculation called for the measurement of the contents of oxygen or CO2 in pulmonary arterial and systemic arterial blood. These values could not be determined directly in human subjects until the acceptance of cardiac catheterization as a clinical procedure in 1940. In the meanwhile, several attempts were made to perfect respiratory methods for the indirect determination of blood-gas contents by respiratory techniques that yielded estimates of the mixed venous and pulmonary capillary gas pressures. The immediate uptake of nonresident gases can be used in a similar way to calculate cardiac output, with the added advantage that they are absent from the mixed venous blood. The fact that these procedures are safe and relatively nonintrusive makes them attractive to physiologists, pharmacologists, and sports scientists as well as to clinicians concerned with the physiopathology of the heart and lung. This paper outlines the development of these techniques, with a discussion of some of the ways in which they stimulated research into the transport of gases in the body through the alveolar membrane.


1963 ◽  
Vol 18 (5) ◽  
pp. 933-936 ◽  
Author(s):  
P. Harris ◽  
T. Bailey ◽  
M. Bateman ◽  
M. G. Fitzgerald ◽  
J. Gloster ◽  
...  

The concentrations of lactic acid, pyruvic acid, glucose, and free fatty acids have been measured simultaneously in the blood from the pulmonary and brachial arteries at rest and during exercise in a group of patients with acquired heart disease. The arteriovenous differences in the concentration of lactate, pyruvate, and free fatty acid were such as could be attributed to chance. The average concentration of glucose was slightly but significantly higher in the brachial arterial blood than in the mixed venous blood. cardiac output; lung metabolism; exercise Submitted on January 15, 1963


1980 ◽  
Vol 58 (9) ◽  
pp. 1078-1085 ◽  
Author(s):  
Y. C. Pang ◽  
P. E. Reid ◽  
D. E. Brooks ◽  
K. M. Leighton ◽  
C. Bruce

The uptake and distribution of halothane in dog blood were studied by analysing the whole blood and plasma concentrations of halothane in samples of arterial and mixed venous blood at different times after the induction of anesthesia with constant inspired halothane levels of 1.0, 1.5, 2.0, and 2.5%, respectively. In general a steady state was reached 2–3 h after induction. Comparison of the arterial blood concentration calculated from end-tidal halothane partial pressure with that determined by direct analysis of the blood indicated that halothane in the alveoli and halothane in arterial blood are not in thermodynamic equilibrium. The arterial halothane concentrations calculated from the end-tidal halothane partial pressure assuming equilibrium is much higher than those found experimentally; thus end-tidal halothane partial pressure is not a true measure of blood halothane concentration. The distribution of halothane between the plasma and cells in blood appeared to be sufficiently rapid to be independent of the approach to the steady state.


2002 ◽  
Vol 102 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Johannes J. MAGER ◽  
Pieter ZANEN ◽  
Fred VERZIJLBERGEN ◽  
Cornelius J.J. WESTERMANN ◽  
Tjeerd HAITJEMA ◽  
...  

Pulmonary arteriovenous malformations (PAVMs) are often associated with hereditary haemorrhagic telangiectasia (HHT). The quantification of right-to-left shunts in patients with PAVMs is important in diagnosis and follow up. Traditionally, this shunt is measured by the 100% oxygen method, in which the value for the arteriovenous difference in oxygen content, Cao2-Co2 (where Cao2 is the oxygen content of arterial blood and Co2 is the oxygen content of mixed venous blood) is estimated. Alternative methods consist of measurement of the systemic or renal uptake of 99mTc-labelled macroaggregates of albumin (MAA), which are trapped in pulmonary capillaries, but pass through PAVMs. We first measured Cao2-Co2 in 12 HHT patients before and after embolization of PAVMs. We obtained a mean value of 4.4ml/100ml, instead of the usual 5ml/100ml. Subsequently, we measured right-to-left shunt in 21 HHT patients using the 100% oxygen method and with two different methods involving 99mTc. We used the kidney-lung method (K/L method), in which it is assumed that the right kidney receives 10% of the cardiac output, and we also used a method with two tracers (HSA/MAA method): (1) 99mTc-labelled human serum albumin (HSA) (which passes through pulmonary capillaries) to measure the fraction of the cardiac output perfusing the kidneys, and (2) MAA to measure the shunt fraction. In 35 shunt measurements we evaluated this new technique and the K/L method, by comparing the results with those from the 100% oxygen method. There was poor agreement between the 100% oxygen method and the K/L method, with 95% limits of agreement for the shunt fraction of -15.2% to +15.2%. There was moderate agreement between the 100% oxygen method and the HSA/MAA method, with limits of agreement of -8.3% to +7.7%. We conclude that the different methods cannot replace each other, because the limits of agreement are too wide for clinical use.


2010 ◽  
Vol 55 (No. 9) ◽  
pp. 445-456 ◽  
Author(s):  
M. Patschova ◽  
R. Kabes ◽  
S. Krisova

This research aimed to determine the effect of aerosolized salbutamol administration on systemic and pulmonary hemodynamic, pulmonary mechanics and oxygen balance in healthy horses during general anaesthesia. Six healthy Thoroughbreds (body weight range 471&ndash;587 kg) underwent two general anaesthesias in dorsal recumbency with and without aerosolized salbutamol administration in randomized order with a one month washout period. The anaesthesia was induced by 1.1 mg/kg of xylazine, 0.02 mg/kg of diazepam and 2.2 mg/kg of ketamine, maintained with isoflurane in oxygen and air and horses were mechanically ventilated. Measurement of arterial and pulmonary arterial blood pressures, cardiac output and arterial and mixed venous blood gas analysis was carried out. Spirometry was performed using a Horse-lite. After achieving a steady state, baseline (T<sub>0</sub>) values of cardiac output, systemic and pulmonary arterial blood pressures, heart rate, dynamic compliance, airway resistance and arterial and mixed venous blood gas values and pH were recorded in both groups. In the S-group (salbutamol), 2 &micro;g/kg of aerosolized salbutamol were administered synchronously with inspirium into the tracheal tube. In both groups data were recorded at 15, 30, 45 and 60 min (T<sub>15</sub>, T<sub>30</sub>, T<sub>45</sub>, T<sub>60</sub>) after the baseline. PaO<sub>2</sub>/FiO<sub>2</sub> ratio, oxygen consumption (VO<sub>2</sub>), oxygen delivery (DO<sub>2</sub>), pulmonary shunt values were calculated. Data were tested for normality and compared within each group: T<sub>0</sub> value with T<sub>15</sub>, T<sub>30</sub>, T<sub>45</sub>, T<sub>60</sub> values using Wilcoxon's test with Bonferoni correction (significance level 0.0125). For each time point, comparisons were made between the S- and C-groups (control) using Wilcoxon's test. In the S-group, there was a significant increase in values (mean &plusmn; SD) of cardiac output (l/min), T<sub>0</sub> (38 &plusmn; 7), a peak at T<sub>15</sub> (64 &plusmn; 25.5), significantly higher values persisted throughout the period of anaesthesia; heart rate (beats/min), T<sub>0</sub> (32 &plusmn; 2), T<sub>15</sub> (40 &plusmn; 6), T<sub>30</sub> (38 &plusmn; 5); DO<sub>2</sub> (l/min), T<sub>0</sub> (5.8 &plusmn; 0.8), a peak at T<sub>15</sub> (9.6 &plusmn; 3.2), significantly higher values persisted until the end of anaesthesia and VO<sub>2</sub> (l/min), T<sub>0</sub> (1.1 &plusmn; 0.5), T<sub>30</sub> (1.6 &plusmn; 0.7) and T<sub>45</sub> (1.8 &plusmn; 0.5). In the C-group, there was a significant decrease in values of PaO<sub>2</sub>/FiO<sub>2</sub> ratio from T<sub>0</sub> (176 &plusmn; 67) to a minimum at T<sub>60</sub> (114 &plusmn; 36) and in DO<sub>2</sub> from T<sub>0</sub> (6 &plusmn; 2.3) to a minimum at T<sub>60</sub> (4.3 &plusmn; 1.2). A comparison of the S- and C-groups did not reveal any difference in the baseline data. Subsequently, significantly higher values of cardiac output, heart rate, DO<sub>2</sub>, and the PaO<sub>2</sub>/FiO<sub>2 </sub>ratio were found in the S-group compared to the C-group. Pulmonary arterial blood pressure was significantly lower in the S-group. Aerosolized salbutamol administration in healthy horses during general anaesthesia caused hemodynamic changes which resulted in an elevation of oxygen delivery. It can have a positive effect on arterial oxygenation, but the effect varies between individuals.


2019 ◽  
pp. 203-206
Author(s):  
Mevlut Demir ◽  
◽  
Muslum Sahin ◽  
Ahmet Korkmaz ◽  
◽  
...  

Carbon monoxide intoxication occurs usually via inhalation of carbon monoxide that is emitted as a result of a fire, furnace, space heater, generator, motor vehicle. A 37-year-old male patient was admitted to the emergency department at about 5:00 a.m., with complaints of nausea, vomiting and headache. He was accompanied by his wife and children. His venous blood gas measures were: pH was 7.29, partial pressure of carbon dioxide (pCO2) was 42 mmHg, partial pressure of oxygen (pO2) was 28 mmHg, carboxyhemoglobin (COHb) was 12.7% (reference interval: 0.5%-2.5%) and oxygen saturation was 52.4%. Electrocardiogram (ECG) examination showed that the patient was not in sinus rhythm but had atrial fibrillation. After three hours the laboratory examination was repeated: Troponin was 1.2 pg/ml and in the arterial blood gas COHb was 3%. The examination of the findings on the monitor showed that the sinus rhythm was re-established. The repeated ECG examination confirmed the conversion to the sinus rhythm. He was monitored with the normobaric oxygen administration.


1979 ◽  
Vol 57 (5) ◽  
pp. 385-388 ◽  
Author(s):  
R. D. Latimer ◽  
G. Laszlo

1. The left lower lobe of the lungs of six anaesthetized dogs were isolated by the introduction of a bronchial cannula at thoracotomy. Catheters were introduced into the main pulmonary artery and a vein draining the isolated lobe. 2. Blood-gas pressures and pH were measured across the isolated lobe and compared with gas pressures in alveolar samples from the lobe. 3. When the isolated lobe was allowed to reach gaseous equilibrium with pulmonary arterial blood for 30 min, there was no significant difference between alveolar and pulmonary venous Pco2. Mean values of whole-blood base excess were similar in pulmonary arterial and pulmonary venous blood. 4. After injection of 20 ml of 8·4% sodium bicarbonate solution into a peripheral vein, Pco2, pH and plasma bicarbonate concentrations rose in the mixed venous blood. There was no change of whole-blood base excess across the lung, indicating that HCO−3, as distinct from dissolved CO2, did not enter lung tissue in measurable amounts. 5. No systematic alveolar—pulmonary venous Pco2 differences were demonstrated in this preparation other than those explicable by maldistribution of lobar blood flow.


1962 ◽  
Vol 17 (1) ◽  
pp. 126-130
Author(s):  
Leon Bernstein ◽  
Chiyoshi Yoshimoto

The analyzer described was de signed for measuring the concentration of carbon dioxide in the bag of gas from which the subject rebreathes in the “rebreathing method” for estimating the tension of carbon dioxide in mixed venous blood. Its merits are that it is cheap, robust, simple to construct and to service, easy to operate, and accurate when used by untrained operators. (Medical students, unacquainted with the instrument, and working with written instructions only, obtained at their first attempt results accurate to within ±0.36% [sd] of carbon dioxide.) The instrument is suitable for use by nurse or physician at the bedside, and also for classes in experimental physiology. Some discussion is presented of the theoretical principles underlying the design of analyzers employing thermal conductivity cells. Submitted on July 13, 1961


Author(s):  
Kirsty L. Ress ◽  
Gus Koerbin ◽  
Ling Li ◽  
Douglas Chesher ◽  
Phillip Bwititi ◽  
...  

AbstractObjectivesVenous blood gas (VBG) analysis is becoming a popular alternative to arterial blood gas (ABG) analysis due to reduced risk of complications at phlebotomy and ease of draw. In lack of published data, this study aimed to establish reference intervals (RI) for correct interpretation of VBG results.MethodsOne hundred and 51 adult volunteers (101 females, 50 males 18–70 y), were enrolled after completion of a health questionnaire. Venous blood was drawn into safePICO syringes and analysed on ABL827 blood gas analyser (Radiometer Pacific Pty. Ltd.). A non-parametric approach was used to directly establish the VBG RI which was compared to a calculated VBG RI based on a meta-analysis of differences between ABG and VBGResultsAfter exclusions, 134 results were used to derive VBG RI: pH 7.30–7.43, partial pressure of carbon dioxide (pCO2) 38–58 mmHg, partial pressure of oxygen (pO2) 19–65 mmHg, bicarbonate (HCO3−) 22–30 mmol/L, sodium 135–143 mmol/L, potassium 3.6–4.5 mmol/L, chloride 101–110 mmol/L, ionised calcium 1.14–1.29 mmol/L, lactate 0.4–2.2 mmol/L, base excess (BE) −1.9–4.5 mmol/L, saturated oxygen (sO2) 23–93%, carboxyhaemoglobin 0.4–1.4% and methaemoglobin 0.3–0.9%. The meta-analysis revealed differences between ABG and VBG for pH, HCO3−, pCO2 and pO2 of 0.032, −1.0 mmol/L, −4.2 and 39.9 mmHg, respectively. Using this data along with established ABG RI, calculated VBG RI of pH 7.32–7.42, HCO3− 23 – 27 mmol/L, pCO2 36–49 mmHg (Female), pCO2 39–52 mmHg (Male) and pO2 43–68 mmHg were formulated and compared to the VBG RI of this study.ConclusionsAn adult reference interval has been established to assist interpretation of VBG results.


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