The Relationship between Arterial and Central Venous Blood Gases Values in Patients Undergoing Mechanical Ventilation after Cardiac Surgery

Introduction: Studies have shown that there is a complex relationship between lactate and ScvO2. Methods: A retrospective study was carried out in 37 intensive care patients with sepsis or septic shock. The relationship between lactate and ScvO2 was explored with correlation analysis and simple linear modelling. Results: Lactate and ScvO2 were significantly correlated in patients with septic shock (r2 = 0.46, p = 0.001; y = -4.11x+ 82.62), but not in sepsis. y Significant correlation between these parameters was also found in the group of patients who went on to die (r2 = 0.67, p < 0.01; y = -3.70x + 78.61), but not in patients who survived. Conclusions: In sepsis, the correlation between ScvO2 and lactate is not constant over the sepsis course and may be dynamic. In the resuscitation of sepsis and/or septic shock, changes in ScvO2 requires further study.

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MONITORING OF CENTRAL-VENOUS-BLOOD GASES DURING OPERATION

The Lancet ◽

10.1016/s0140-6736(73)93237-6 ◽

1973 ◽

Vol 302 (7825) ◽

pp. 385

Author(s):

EugeneD. Gierson

Keyword(s):

Venous Blood ◽

Blood Gases ◽

Central Venous ◽

Central Venous Blood

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Association of intraoperative blood gas analysis with patient outcome after adult cardiac surgery

10.21203/rs.2.1748/v2 ◽

2019 ◽

Author(s):

Shaopeng Gang ◽

Ling Jiang ◽

Kaiyun Fang ◽

Xiulun Liu ◽

Daokang Xiang ◽

...

Keyword(s):

Cardiac Surgery ◽

Venous Blood ◽

Jugular Bulb ◽

Blood Gas ◽

Central Venous ◽

Blood Samples ◽

Central Venous Blood ◽

Blood Ph ◽

Blood Gas Parameters ◽

Adult Cardiac Surgery

Abstract Background: The associations of the different blood gas parameters from different blood samples harvested at different stages during adult cardiac surgery with the postoperative outcomes are inadequately studied. Methods: Adult patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) participated in this prospective observational study. Blood gas parameters from arterial, central venous, and jugular bulb venous blood samples harvested simultaneously at pre-determined time points (baseline with the patient awake, post-anesthesia induction but before CPB, during CPB at 30°C, during CPB at 37°C (rewarming), and at the end of surgery) were correlated with postoperative outcomes including the length of mechanical ventilation (LMV), intensive care unit stay (LICU), hospital stay (LOH), and major organ morbidity and mortality. Results: Data from 193 patients were analyzed. Multiple parameters of different blood harvested at different stages significantly correlated with one or more outcome measures based on univariate analysis (p < 0.05). However, only the jugular bulb venous blood pH and carbon dioxide tension and the central venous blood pH at the end of surgery (pHcv-end) were significantly correlated with LMV, LICU, and LOH (p < 0.05). A more alkaline blood correlated with more favorable outcomes. After adjusting for age, surgical time, and total intravenous volume administered, multivariate analysis showed that only pHcv-end remained independently associated with LMV and LICU (p < 0.05). Conclusion: More alkaline blood, especially the central venous blood at the end of surgery, is associated with more favorable outcomes after adult cardiac surgery. Trial registration ChiCTR-POC-17013942, Date of registration December 15, 2017.

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Association of intraoperative blood gas analysis with patient outcome after adult cardiac surgery

10.21203/rs.2.1748/v1 ◽

2019 ◽

Author(s):

Shaopeng Gang ◽

Ling Jiang ◽

Kaiyun Fang ◽

Xiulun Liu ◽

Daokang Xiang ◽

...

Keyword(s):

Cardiac Surgery ◽

Venous Blood ◽

Postoperative Outcomes ◽

Blood Gas ◽

Central Venous ◽

Blood Samples ◽

Central Venous Blood ◽

Blood Ph ◽

Blood Gas Parameters ◽

Adult Cardiac Surgery

Abstract Background: The associations of the different blood gas parameters from different blood samples harvested at different stages during adult cardiac surgery with the postoperative outcomes are inadequately studied. Methods: Adult patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) participated in this prospective observational study. Blood gas parameters from arterial, central venous, and jugular venous blood samples harvested simultaneously at pre-determined time points (baseline with the patient awake, post-anesthesia induction but before CPB, during CPB at 30°C, during CPB at 37°C (rewarming), and at the end of surgery) were correlated with postoperative outcomes including the length of mechanical ventilation (LMV), intensive care unit stay (LICU), hospital stay (LOH), and major organ morbidity and mortality. Results: Data from 193 patients were analyzed. Multiple parameters of different blood harvested at different stages significantly correlated with one or more outcome measures based on univariate analysis (p < 0.05). However, only the jugular venous blood pH and carbon dioxide tension and the central venous blood pH at the end of surgery (pHcv-end) were significantly correlated with LMV, LICU, and LOH (p < 0.05). A more alkaline blood correlated with more favorable outcomes. After adjusting for age, surgical time, and total intravenous volume administered, multivariate analysis showed that only pHcv-end remained independently associated with LMV and LICU (p < 0.05). Conclusion: More alkaline blood, especially the central venous blood at the end of surgery, is associated with more favorable outcomes after adult cardiac surgery. Trial registration ChiCTR-POC-17013942, Date of registration December 15, 2017.

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A Comparison Between Arterial Blood Gases, Peripheral Venous Blood Gases, and Central Venous Blood Gases in Severe Sepsis and Septic Shoc

CHEST Journal ◽

10.1378/chest.1390579 ◽

2012 ◽

Vol 142 (4) ◽

pp. 408A

Author(s):

Heath White ◽

Pedro Quiroga ◽

Juhee Song ◽

Alfredo Vazquez-Sandoval ◽

Alejandro Arroliga ◽

...

Keyword(s):

Severe Sepsis ◽

Venous Blood ◽

Blood Gases ◽

Arterial Blood Gases ◽

Central Venous ◽

Peripheral Venous Blood ◽

Central Venous Blood ◽

Arterial Blood

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The Position of Central Venous Catheters Inserted through Arm Veins: A Preliminary Report

Anaesthesia and Intensive Care ◽

10.1177/0310057x7400200105 ◽

1974 ◽

Vol 2 (1) ◽

pp. 43-47 ◽

Cited By ~ 12

Author(s):

D. G. Woods ◽

Jean Lumley ◽

W. J. Russell ◽

R. D. Jack

Keyword(s):

Preliminary Report ◽

Heart Surgery ◽

Venous Pressure ◽

Venous Blood ◽

Open Heart Surgery ◽

Central Venous Catheters ◽

Open Heart ◽

Central Venous ◽

Central Venous Blood ◽

Catheter Tip

Fifty-three central venous catheters were followed up by radiography or direct observation during open-heart surgery. Forty of these were satisfactorily positioned for recording central venous pressure or for sampling central venous blood. Radiography showed that the catheter tip was in an unsatisfactory position in 21 per cent of cases. It is recommended that radiographic confirmation of the site of the catheter tip be obtained as a routine and if necessary the catheter can be re-positioned and another radiograph taken.

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Diagnostic Validity of Ratio between Differences of Central Venous to Arterial CO2 and Arterial to Central Venous O2 Content in Diagnosis of Anaerobic Metabolism among Septic Patients

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v8i1.52548 ◽

2021 ◽

Vol 8 (1) ◽

pp. 34-38

Author(s):

Subroto Kumar Sarker ◽

Umme Kulsum Choudhury ◽

Mohammad Mohsin ◽

Subrata Kumar Mondal ◽

Muslema Begum

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Intensive Care ◽

Anaerobic Metabolism ◽

Venous Blood ◽

Blood Gases ◽

Serum Lactate ◽

Central Venous ◽

College Hospital ◽

Sepsis And Septic Shock

Background: Detection of anaerobic metabolism is very crucial for the management of the septic patients. Objective: The purpose of the present study was to validate the ratio between differences of central venous to arterial CO2 and arterial to central venous O2 content in diagnosis of anaerobic metabolism among septic patients. Methodology: This prospective observational study was conducted in the Intensive Care Unit of the department of Anaesthesia Analgesia, Palliative and Intensive Care Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to December 2016. All patients admitted to ICU with the features of severe sepsis and septic shock according to SSC guidelines with the age of more than or equal to 18 years in both sexes were included in this study. The arterial and central venous blood gases were measure simultaneously. At the same time serum lactate was measured. Result: Among the 69 patients, 31(44.9%) were of severe sepsis and 38(55%) were of septic shock patients. In the severe sepsis and septic shock patients the mean P(v-a)CO2/C(a-v)O2 is 1.39±0.41 and 1.11±0.40 respectively. Serum lactate in case of severe sepsis and septic shock patients is 2.85±1.40 and 3.85±1.04 respectively. The ROC analysis showed an area under curve 0.89 and P(v-a)CO2/C(a-v)O2 ratio cutoff value of 1.21 showed sensitivity 0.84 and specificity 0.94. Conclusion: The P(v-a)CO2/C(a-v)O2 ratio is also a another marker of global anaerobic metabolism and it would be used for diagnosis as well as management of septic patient. Journal of Current and Advance Medical Research, January 2021;8(1):34-38

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