Impact of mechanical power and positive end expiratory pressure on central vs. mixed oxygen and carbon dioxide related variables in a population of female piglets

Author:

Fioccola Antonio12,Pozzi Tommaso13,Fratti Isabella13,Nicolardi Rosmery Valentina14,Romitti Federica1,Busana Mattia1,Collino Francesca5,Camporota Luigi67,Meissner Konrad1,Moerer Onnen1,Gattinoni Luciano1ORCID

Affiliation:

1. Department of Anesthesiology University Medical Center Göttingen Göttingen Germany

2. Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine University of Florence Florence Italy

3. Department of Health Sciences University of Milan Milan Italy

4. IRCCS San Raffaele Scientific Institute Milan Italy

5. Department of Surgical Sciences University of Turin Turin Italy

6. Department of Adult Critical Care Guy's & St Thomas' NHS foundation Trust London UK

7. Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences King's College London London UK

Abstract

AbstractIntroductionThe use of the pulmonary artery catheter has decreased overtime; central venous blood gases are generally used in place of mixed venous samples. We want to evaluate the accuracy of oxygen and carbon dioxide related parameters from a central versus a mixed venous sample, and whether this difference is influenced by mechanical ventilation.Materials and MethodsWe analyzed 78 healthy female piglets ventilated with different mechanical power.ResultsThere was a significant difference in oxygen‐derived parameters between samples taken from the central venous and mixed venous blood (SO2 = 74.6%, ScvO2 = 83%, p < 0.0001). Conversely, CO2‐related parameters were similar, with strong correlation. Ventilation with higher mechanical power and PEEP increased the difference between oxygen saturations, (Δ[ScvO2−SO2 ] = 7.22% vs. 10.0% respectively in the low and high MP groups, p = 0.020); carbon dioxide‐related parameters remained unchanged (p = 0.344).ConclusionsThe venous oxygen saturation (central or mixed) may be influenced by the effects of mechanical ventilation. Therefore, central venous data should be interpreted with more caution when using higher mechanical power. On the contrary, carbon dioxide‐derived parameters are more stable and similar between the two sampling sites, independently of mechanical power or positive end expiratory pressures.

Publisher

Wiley

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