Measured pulmonary oxygen consumption: difference between systemic oxygen uptake measured by the reverse Fick method and indirect calorimetry in cardiac surgery

Peyton, Philip J; Robinson, Gavin J. B.

doi:10.1111/j.1365-2044.2004.04044.x

Cited by 21 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite these concerns, the reverse Fick method provides a useful standard to assess bias and accuracy in another method provided that a large enough series of data is collected to reduce the standard error of the mean, and an allowance is made for the presence of lung tissue uptake, which is not measured by the reverse Fick approach. Calculation of the mean bias of 13.5% found in this current study is consistent with values measured by previous workers 14,[25][26][27] . This has been attributed to lung tissue uptake of O 2 , although another likely contributing factor is net elimination of N 2 by the body.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

In Vivo Validation of the M-COVX® Metabolic Monitor in Patients under Anaesthesia

Stuart-Andrews

Peyton

Robinson

et al. 2007

Anaesth Intensive Care

Self Cite

View full text Add to dashboard Cite

A practical method of breath-by-breath monitoring of metabolic gas exchange has been developed by GE Healthcare/Datex Ohmeda and incorporated into existing anaesthetic and critical care monitoring systems (M-COVX ® ). This device relates flow measurements made at the mouth by pneumotachograph to measurements of inspired and expired gas composition by matching the two waveforms thereby allowing continuous, breath-by-breath monitoring of an intubated patient's oxygen uptake and carbon dioxide production. Given that there is a paucity of data comparing this new device against methods more widely used clinically, we tested the device on 11 patients undergoing cardiopulmonary bypass surgery. Using a standard anaesthetic machine (Datex Ohmeda Excel 210 SE) with a semi-closed circle absorber system, oxygen uptake was measured at the mouth continuously throughout the operation at approximately six-second intervals. The data were compared against the reverse Fick method and against standard indirect calorimetry using the Haldane transformation. When compared to the calculated reverse Fick oxygen uptake, a mean difference of +16.5% was found pre-bypass and +9.9% post-bypass, consistent with uptake of oxygen by lung tissue, which is not taken into account by the reverse Fick method. Measurements made comparing the M-COVX metabolic monitor against which this device can be incorporated into existing anaesthetic monitoring systems and its accuracy in measuring oxygen uptake, the M-COVX module is an attractive addition to existing perioperative monitoring.

show abstract

Section: Discussionsupporting

confidence: 93%

“…The standard deviation (SD) in their study at a similar FiO 2 was 28 ml.min -1 compared to our own SD of 31 ml.min -1 when comparing the M-COVX with the standard Haldane method. This level of precision is typical of studies comparing different methods for measurement of lung gas uptake in the clinical setting 1,3,14,15 .…”

Section: Discussionmentioning

confidence: 89%

In Vivo Validation of the M-COVX® Metabolic Monitor in Patients under Anaesthesia

Stuart-Andrews

Peyton

Robinson

et al. 2007

Anaesth Intensive Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…The first is that a component of VO 2 measured by the device is the metabolic oxygen consumed by the lung itself, which would increase measured VO 2 relative to that transferred to blood in the pulmonary circulation (which is the relevant variable in Fick transport). This phenomenon may account for ~10%‐12% of measured VO 2 , and would overestimate CO in Fick O2 by the same degree that we did . Another potential source of error is the transpleural diffusive loss of oxygen through the visceral pleura in the setting of an open sternum, which would contribute to measured VO 2 but again, not part of the net oxygen uptake in the pulmonary circulation.…”

Section: Discussionmentioning

confidence: 66%

Changes in tissue oxygen tension, venous saturation, and Fick‐based assessments of cardiac output during hyperoxia

Perry

Thomson

Pigula

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…In all included studies, oxygen consumption was assessed either by breathing gas analysis, such as indirect calorimetry, or calculated by the reversed‐Fick method using thermodilution cardiac output by a pulmonary artery or right ventricle catheter. The reported inconsistencies between these two methodologies could be attributed to the fact that the reversed‐Fick method does not include the pulmonary oxygen consumption and may combine measurement errors of oxygen content variables . Measuring gas fractions in expired air, on the other hand, implies other difficulties.…”

Section: Discussionmentioning

confidence: 99%

The effects of general anaesthesia on oxygen consumption: A meta‐analysis guiding future studies on perioperative oxygen transport

Jakobsson

Vadman

Hagel

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Funding informationDepartmental funding only.Background: Increased oxygen extraction, the ratio of consumption to delivery, has been associated with poor outcome after surgery. Oxygen consumption (VO2) can change in several ways in the perioperative period, but is seldom monitored directly in routine care. This study investigates the effects of general anaesthesia on VO2. Methods:We searched PubMed, EMBASE, and Cochrane Library 1946-2018 for studies including VO2 measurements before and after anaesthesia induction. Quality was assessed by Cochrane risk of bias tool and NIH Quality Assessment tool for before-and-after studies. Changes in VO2 after anaesthesia induction were pooled in a random effects model meta-analysis with standardized mean differences transformed to absolute changes of VO2. Changes in VO2 after surgical incision and after recovery from anaesthesia were analysed as secondary outcomes in the included studies. Results:Twenty-four studies including 453 patients were analysed for VO2 changes induced by anaesthesia. Studies were published during 1969-2000 and mean age of patients ranged 28-70 years. VO2 decreased after anaesthesia induction by −65 (−75; −55, 95% CI) mL min −1 and indexed VO2 (VO2I) by −33 (−38; −28, 95% CI) mL min −1 m −2 . After surgical incision and in the post-operative period VO2 increased again. Heterogeneity was considerable among the studies and the overall quality of evidence was very low. Conclusions:General anaesthesia probably reduces oxygen consumption but the effect estimate is uncertain. Given the limited generalizability and low quality of the available evidence, new studies in modern perioperative settings and in today's older high-risk surgical patient populations are needed.

show abstract

Measured pulmonary oxygen consumption: difference between systemic oxygen uptake measured by the reverse Fick method and indirect calorimetry in cardiac surgery

Cited by 21 publications

References 20 publications

In Vivo Validation of the M-COVX® Metabolic Monitor in Patients under Anaesthesia

In Vivo Validation of the M-COVX® Metabolic Monitor in Patients under Anaesthesia

Changes in tissue oxygen tension, venous saturation, and Fick‐based assessments of cardiac output during hyperoxia

The effects of general anaesthesia on oxygen consumption: A meta‐analysis guiding future studies on perioperative oxygen transport

Contact Info

Product

Resources

About