Respiratory and circulatory analysis of CO2 output during exercise in chronic heart failure.

Hachamovitch, Rory; Brown, Harvey V.; Rubin, Stanley A.

doi:10.1161/01.cir.84.2.605

Cited by 34 publications

(19 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is also plausible that disease states affecting venous and arterial flow would result in a greater disparity between the measured variables in the PVBG and ABG. Conditions that affect venous return and cardiac output (and consequently venous and arterial blood flow) include cardiac failure, circulatory shock of any cause, respiratory failure and obesity, all of which are common in patients presenting to the ED . The site of PVBG collection is also important, as the measured values may differ depending on the metabolic activity of the tissues distal to the point of collection.…”

Section: Introductionmentioning

confidence: 99%

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

et al. 2014

View full text Add to dashboard Cite

Peripheral venous blood gas (PVBG) analysis is increasingly being used as a substitute for arterial blood sampling; however, comparability has not been clearly established. To determine if the pH, PCO2 and PO2 obtained from PVBG analysis is comparable with arterial blood gas (ABG) analysis. A search was conducted of electronic databases as well as handsearching of journals and reference lists through December 2012 to identify studies comparing PVBG with ABG analysis in adult subjects. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A meta-analysis using a random effects model was used to calculate the average difference (bias) and the limits of agreement for the venous and arterial pH, PCO2 and PO2. A total of 18 studies comprising 1768 subjects were included in the meta-analysis. There was considerable heterogeneity between studies with I 2 approaching 100%. There was little difference between the pH obtained from the PVBG and the ABG, with the arterial pH typically 0.03 higher than the venous pH (95% confidence interval 0.029-0.038). The venous and arterial PCO2 were not comparable because the 95% prediction interval of the bias for venous PCO2 was unacceptably wide, extending from −10.7 mm Hg to +2.4 mm Hg. The PO2 values compared poorly, the arterial PO2 typically 36.9 mm Hg greater than the venous with significant variability (95% confidence interval from 27.2 to 46.6 mm Hg). PVBG analysis compares well with ABG analysis for pH estimations in adults but not to the PCO2 or PO2. These differences are sufficiently large to be of clinical significance.

show abstract

Section: Introductionmentioning

confidence: 99%

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Given that RQ normalized after retransfusion, the increased P v-a CO 2 /C a-v O 2 should be ascribed to increased release of CO 2 from hemoglobin, not to tissue hypoxia. The persistent P v-a CO 2 /C a-v O 2 elevation might result from changes in venous oxygen saturation (Haldane effect) and hemoglobin levels and mostly from persistent hyperlactatemia [30, 31]. All these factors can shift the CO 2 Hb dissociation curve.…”

Section: Discussionmentioning

confidence: 99%

Systemic and microcirculatory effects of blood transfusion in experimental hemorrhagic shock

Ferrara

Edul

Canales

et al. 2017

ICMx

View full text Add to dashboard Cite

BackgroundThe microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition, the identification of anaerobic metabolism is elusive. The venoarterial PCO2 to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2) might be a surrogate for respiratory quotient, but this has not been validated. Therefore, our goal was to characterize sublingual and intestinal (mucosal and serosal) microvascular injury after blood resuscitation in hemorrhagic shock and its relation with O2 and CO2 metabolism.MethodsAnesthetized and mechanically ventilated sheep were assigned to stepwise bleeding and blood retransfusion (n = 10) and sham (n = 7) groups. We performed analysis of expired gases, arterial and mixed venous blood gases, and intestinal and sublingual videomicroscopy.ResultsIn the bleeding group during the last step of hemorrhage, and compared to the sham group, there were decreases in oxygen consumption (3.7 [2.8–4.6] vs. 6.8 [5.8–8.0] mL min−1 kg−1, P < 0.001) and increases in respiratory quotient (0.96 [0.91–1.06] vs. 0.72 [0.69–0.77], P < 0.001). Retransfusion normalized these variables. The Pv-aCO2/Ca-vO2 increased in the last step of bleeding (2.4 [2.0–2.8] vs. 1.1 [1.0–1.3], P < 0.001) and remained elevated after retransfusion, compared to the sham group (1.8 [1.5–2.0] vs. 1.1 [0.9–1.3], P < 0.001). Pv-aCO2/Ca-vO2 had a weak correlation with respiratory quotient (Spearman R = 0.42, P < 0.001). All the intestinal and sublingual microcirculatory variables were affected during hemorrhage and improved after retransfusion. The recovery was only complete for intestinal red blood cell velocity and sublingual total and perfused vascular densities.ConclusionsAlthough there were some minor differences, intestinal and sublingual microcirculation behaved similarly. Therefore, sublingual mucosa might be an adequate window to track intestinal microvascular reperfusion injury. Additionally, Pv-aCO2/Ca-vO2 was poorly correlated with respiratory quotient, and its physiologic behavior was different. Thus, it might be a misleading surrogate for anaerobic metabolism.Electronic supplementary materialThe online version of this article (doi:10.1186/s40635-017-0136-3) contains supplementary material, which is available to authorized users.

show abstract

“…From the Department of Veteran Affairs, Greater Los Angeles Healthcare System, ratory function and gas exchange, thermoregulation, and neuroendocrine homeostasis (7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Although the targets of exercise training are largely noncardiac, beneficial effects on the heart may occur through circulatory coupling that we now understand and routinely accept as determinants of cardiac function in heart failure.…”

Section: See Page 2329mentioning

confidence: 99%

Exercise Training in Heart Failure

Rubin

2007

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Respiratory and circulatory analysis of CO2 output during exercise in chronic heart failure.

Cited by 34 publications

References 19 publications

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta‐analysis

Systemic and microcirculatory effects of blood transfusion in experimental hemorrhagic shock

Exercise Training in Heart Failure

Contact Info

Product

Resources

About