BACKGROUND: An increase in intramucosal-arterial Pco2 gradient (DeltaPco2) might be caused by tissue hypoxia or by diminished blood flow. Our hypothesis was that DeltaPco2 should not be altered in anemic hypoxia with preserved blood flow. METHODS: In 18 anesthetized, mechanically ventilated sheep, oxygen transport was stepwise reduced by hemorrhage (hypovolemia, n = 9) or by hemorrhage and simultaneous dextran infusion (hemodilution, n = 9). RESULTS: Hypovolemia and hemodilution produced comparable decreases in systemic and intestinal oxygen transport and uptake. However, mixed venoarterial and mesenteric venoarterial Pco2 gradients and DeltaPco2 were significantly higher in hypovolemia than in hemodilution (25 +/- 5 vs. 10 +/- 2 mm Hg; 21 +/- 6 vs. 10 +/- 5 mm Hg; and 41 +/- 18 vs. 14 +/- 9 mm Hg, respectively; p < 0.01). CONCLUSION: DeltaPco2 did not reflect intestinal dysoxia during Vo2/Do2 dependency attributable to hemodilution. Blood flow seems to be the main determinant of DeltaPco2.
BACKGROUND: An increase in intramucosal-arterial Pco2 gradient (DeltaPco2) might be caused by tissue hypoxia or by diminished blood flow. Our hypothesis was that DeltaPco2 should not be altered in anemic hypoxia with preserved blood flow. METHODS: In 18 anesthetized, mechanically ventilated sheep, oxygen transport was stepwise reduced by hemorrhage (hypovolemia, n = 9) or by hemorrhage and simultaneous dextran infusion (hemodilution, n = 9). RESULTS:Hypovolemia and hemodilution produced comparable decreases in systemic and intestinal oxygen transport and uptake. However, mixed venoarterial and mesenteric venoarterial Pco2 gradients and DeltaPco2 were significantly higher in hypovolemia than in hemodilution (25 +/- 5 vs. 10 +/- 2 mm Hg; 21 +/- 6 vs. 10 +/- 5 mm Hg; and 41 +/- 18 vs. 14 +/- 9 mm Hg, respectively; p < 0.01). CONCLUSION: DeltaPco2 did not reflect intestinal dysoxia during Vo2/Do2 dependency attributable to hemodilution. Blood flow seems to be the main determinant of DeltaPco2.
Authors: Gustavo A Ospina-Tascón; Mauricio Umaña; William Bermúdez; Diego F Bautista-Rincón; Glenn Hernandez; Alejandro Bruhn; Marcela Granados; Blanca Salazar; César Arango-Dávila; Daniel De Backer Journal: Intensive Care Med Date: 2015-03-20 Impact factor: 17.440
Authors: Gustavo A Ospina-Tascón; Diego F Bautista-Rincón; Mauricio Umaña; José D Tafur; Alejandro Gutiérrez; Alberto F García; William Bermúdez; Marcela Granados; César Arango-Dávila; Glenn Hernández Journal: Crit Care Date: 2013-12-13 Impact factor: 9.097
Authors: Gustavo A Ospina-Tascón; Mauricio Umaña; William F Bermúdez; Diego F Bautista-Rincón; Juan D Valencia; Humberto J Madriñán; Glenn Hernandez; Alejandro Bruhn; César Arango-Dávila; Daniel De Backer Journal: Intensive Care Med Date: 2015-11-17 Impact factor: 17.440