Computer-Assisted Analysis of the Impact of Respiratory Quotient on Blood CO2Tension and pH Changes

Giovannini, Ivo; Chiarla, Carlo; Boldrini, Giuseppe; Nuzzo, Gennaro

doi:10.1006/cbmr.1998.1468

Cited by 1 publication

(1 citation statement)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, the marked increase in gastric RQ is consistent with the presence of regional hypoperfusion and hypoxia during epinephrine administration. Indeed, in these conditions, the RQ is better defined as an "exchange ratio," because its value does not reflect a true RQ, but a series of gas exchange interactions, which commonly occur in low blood flow and tissue hypoxia (9). Another aspect and interpretation of the results is that the decreasing proportional magnitude of the Haldane effect over gastric tissue represents low-CO 2 buffering capacity of hemoglobin and other proteins as suggested by Giovannini et al (10).…”

Section: Discussionmentioning

confidence: 99%

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO₂ content gradients and lactate-to-pyruvate ratios

Martikainen¹,

Tenhunen²,

Giovannini³

et al. 2005

American Journal of Physiology-Gastrointestinal and Liver Physi

Self Cite

View full text Add to dashboard Cite

Epinephrine is widely used as a vasoconstrictor or inotrope in shock, although it may typically induce or augment lactic acidosis. Ongoing debate addresses the question of whether hyperlactatemia per se is a sign of tissue perfusion deficit or aerobic glycolysis. We wanted to test the hypothesis that epinephrine has selective detrimental effects on visceral perfusion and metabolism. We performed rigorous regional venous blood gas analyses as well as intraperitoneal microdialysis. We used a mathematical model to calculate regional arteriovenous CO(2) content gradients and estimated the magnitude of the Haldane effect in a porcine model of prolonged hypotensive shock induced by endotoxin infusion (mean arterial blood pressure < 60 mmHg). Subsequently, vasopressors (epinephrine or norepinephrine) were administered and adjusted to maintain systemic mean arterial pressure > 70 mmHg for 4 h. Epinephrine caused systemic hyperlactatemia and acidosis. Importantly, both systemic and regional venous lactate-to-pyruvate ratios increased. Epinephrine was associated with decreasing portal blood flow despite apparently maintained total splanchnic blood flow. Epinephrine increased gastric venous-to-arterial Pco(2) gradients and CO(2) content gradients with decreasing magnitude of the Haldane effect, and the regional gastric respiratory quotient remained higher after epinephrine as opposed to norepinephrine infusion. In addition, epinephrine induced intraperitoneal lactate and glycerol release. We did not observe these adverse hemodynamic or metabolic changes related to norepinephrine with the same arterial pressure goal. We conclude that high CO(2) content gradients with decreasing magnitude of the Haldane effect pinpoint the most pronounced perfusion deficiency to the gastric wall when epinephrine, as opposed to norepinephrine, is used in experimental endotoxin shock.

show abstract

Section: Discussionmentioning

confidence: 99%

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO₂ content gradients and lactate-to-pyruvate ratios

Martikainen¹,

Tenhunen²,

Giovannini³

et al. 2005

American Journal of Physiology-Gastrointestinal and Liver Physi

Self Cite

View full text Add to dashboard Cite

show abstract

Computer-Assisted Analysis of the Impact of Respiratory Quotient on Blood CO2Tension and pH Changes

Cited by 1 publication

References 19 publications

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO₂ content gradients and lactate-to-pyruvate ratios

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO₂ content gradients and lactate-to-pyruvate ratios

Contact Info

Product

Resources

About

Computer-Assisted Analysis of the Impact of Respiratory Quotient on Blood CO2Tension and pH Changes

Cited by 1 publication

References 19 publications

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO2 content gradients and lactate-to-pyruvate ratios

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO2 content gradients and lactate-to-pyruvate ratios

Contact Info

Product

Resources

About

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO₂ content gradients and lactate-to-pyruvate ratios

Epinephrine induces tissue perfusion deficit in porcine endotoxin shock: evaluation by regional CO₂ content gradients and lactate-to-pyruvate ratios