Hemodynamic monitoring with two blood gases: “a tool that does not go out of style”

Abstract

Introduction. Hemodynamic monitoring of a critically ill patient is an indispensable tool both inside and outside intensive care; we currently have invasive, minimally invasive and non-invasive devices; however, no device has been shown to have a positive impact on the patient's evolution; arterial and venous blood gases provide information on the patient's actual microcirculatory and metabolic status and may be a hemodynamic monitoring tool.
 Objective. To carry out a non-systematic review of the literature of hemodynamic monitoring carried out through the variables obtained in arterial and venous blood gases.
 Material and methods. A non-systematic review of the literature was performed in the PubMed, OvidSP and ScienceDirect databases with selection of articles from 2000 to 2019.
 Results. It was found that there are variables obtained in arterial and venous blood gases such as central venous oxygen saturation (SvcO2), venous-to-arterial carbon dioxide pressure (∆pv-aCO2), venous-to-arterial carbon dioxide pressure/arteriovenous oxygen content difference (∆pv-aCO2/∆Ca-vO2) that are related to cellular oxygenation, cardiac output (CO), microcirculatory veno-arterial flow and anaerobic metabolism and allow to assess tissue perfusion status.
 Conclusion. The variables obtained by arterial and venous blood gases allow for non-invasive, accessible and affordable hemodynamic monitoring that can guide medical decision-making in critically ill patients.

Utilidad de la gasometría en el retiro de la ventilación mecánica

“…La utilidad de la gasometría para evaluar el equilibrio ácido base y el intercambio de gases (oxigenación y ventilación) es bien conocida [2]. Sin embargo, también puede clasificar la severidad de un problema pulmonar a través de los índices de oxigenación, llevar a cabo "monitoreo hemodinámico" mediante la saturación venosa central de oxígeno (SvcO 2 ), la diferencia de presión venoarterial de dióxido de carbono (∆Pv-aCO 2 ) o de la diferencia de presión venoarterial de dióxido de carbono/diferencia del contenido arteriovenoso de oxígeno (∆Pv-aCO 2 /∆Ca-vO 2 ) o determinar el pronóstico con los valores del déficit de base (DB) y el lactato [3]. Finalmente, el weaning y el retiro de la VM es el objetivo de esta revisión.…”