Open AccessUsefulness of venous-to-arterial partial pressure of CO2 difference to assess oxygen supply to demand adequacy: effects of dobutamine
Author(s) -
Boulos Nassar,
Jihad Mallat
Publication year - 2019
Publication title -
journal of thoracic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.682
H-Index - 60
eISSN - 2077-6624
pISSN - 2072-1439
DOI - 10.21037/jtd.2019.04.85
Subject(s) - dobutamine , medicine , pco2 , cardiac output , inotrope , shock (circulatory) , partial pressure , perfusion , hemodynamics , cardiogenic shock , oxygen transport , anesthesia , cardiology , oxygen , myocardial infarction , chemistry , organic chemistry
The central venous O 2 saturation value and lactic acid levels are part of the diagnostic and therapeutic work up of patients in shock. These usual indicators of tissue hypoxia don't fully describe the adequacy of tissue perfusion. There is ample evidence that supplementing this data with the venous-to-arterial partial pressure of CO 2 (PCO 2 ) difference (ΔPCO 2 ) complements the clinician's tools when treating patients with shock. Based on a modified Fick equation as it applies to CO 2 , in patients in a steady state, the ΔPCO 2 reflects the cardiac output (CO). This observation has been shown to be of clinical value in resuscitating patients in shock. Moreover, the ΔPCO 2 can be used to titrate inotropes, and differentiate the hemodynamic from the metabolic effect of dobutamine.