Open AccessChanges in central venous-to-arterial carbon dioxide tension induced by fluid bolus in critically ill patients
Author(s) -
Charalampos Pierrakos,
David De Bels,
Thomas Nguyen,
Dimitrios Velissaris,
Rachid Attou,
Jacques Devriendt,
Patrick M. Honoré,
Fabio Silvio Taccone,
Daniel De Backer
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0257314
Subject(s) - medicine , anesthesia , bolus (digestion) , critically ill , cardiac index , hemodynamics , cardiology , cardiac output
Background In this prospective observational study, we evaluated the effects of fluid bolus (FB) on venous-to-arterial carbon dioxide tension (P va CO 2 ) in 42 adult critically ill patients with pre-infusion P va CO 2 > 6 mmHg. Results FB caused a decrease in P va CO 2 , from 8.7 [7.6−10.9] mmHg to 6.9 [5.8−8.6] mmHg (p < 0.01). P va CO 2 decreased independently of pre-infusion cardiac index and P va CO 2 changes during FB were not correlated with changes in central venous oxygen saturation (S cv O 2 ) whatever pre-infusion CI. Pre-infusion levels of P va CO 2 were inversely correlated with decreases in P va CO 2 during FB and a pre-infusion P va CO 2 value < 7.7 mmHg could exclude a decrease in P va CO 2 during FB (AUC: 0.79, 95%CI 0.64–0.93; Sensitivity, 91%; Specificity, 55%; p < 0.01). Conclusions Fluid bolus decreased abnormal P va CO 2 levels independently of pre-infusion CI. Low baseline P va CO 2 values suggest that a positive response to FB is unlikely.