States of low pulmonary blood flow can be detected non-invasively at the bedside measuring alveolar dead space.
We tested whether the ratio of alveolar dead space to alveolar tidal volume (VD(alv)/VT(alv)) can detect states of low pulmonary blood flow (PBF) in a non-invasive way. Fifteen patients undergoing cardiovascular surgeries with cardiopulmonary bypass (CPB) were studied. CPB is a technique that exclud...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 26; no. 3; pp. 183 - 191 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Jun2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104566426&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104566426 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Jun2012 vid: 26 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104566426 NLM22484920 2011548364 10.1007/s10877-012-9358-9 NLM22484920 104566426 ppf: 183 ppct: 8 formats: fmt: @attributes: type: P tig: atl: States of low pulmonary blood flow can be detected non-invasively at the bedside measuring alveolar dead space. aug: au: Tusman G Suarez-Sipmann F Paez G Alvarez J Bohm SH Tusman, Gerardo Suarez-Sipmann, Fernando Paez, Gabriel Alvarez, Jorge Bohm, Stephan H affil: Department of Anesthesiology, Hospital Privado de Comunidad, Mar del Plata, Argentina sug: subj: Clinical Information Systems Pulmonary Circulation Respiratory Dead Space Aged Capnography Statistics and Numerical Data Cardiopulmonary Bypass Female Human Male Middle Age Monitoring, Physiologic Statistics and Numerical Data Prospective Studies Pulmonary Alveoli Physiology Pulmonary Embolism Diagnosis Tidal Volume Ventilator Weaning Aged: 65+ years Middle Aged: 45-64 years Female Male ab: We tested whether the ratio of alveolar dead space to alveolar tidal volume (VD(alv)/VT(alv)) can detect states of low pulmonary blood flow (PBF) in a non-invasive way. Fifteen patients undergoing cardiovascular surgeries with cardiopulmonary bypass (CPB) were studied. CPB is a technique that excludes the lungs from the general circulation. The weaning of CPB is a model that manipulates PBF in vivo because each time blood flow through the CPB decreases, expected PBF (ePBF) increases. Patients were liberated from CPB in steps of 20 % every 2' starting from 100 % CPB (very low ePBF) to 0 % CPB (100 % ePBF). During constant ventilation, volumetric capnograms were recorded and Bohr's dead space ratio (VD(Bohr)/VT), VD(alv)/VT(alv) and the ratio of airway dead space to tidal volume (VD(aw)/VT) were calculated. Before CPB, VD(Bohr)/VT was 0.36 ± 0.05, VD(aw)/VT 0.21 ± 0.04 and VD(alv)/VT(alv) 0.18 ± 0.06 (mean ± SD). During weaning from CPB, VD(aw)/VT remained unchanged while VD(Bohr)/VT and VD(alv)/VT(alv) decreased with increasing ePBF. At CPB of 80, 60, 40 and 20 % VD(Bohr)/VT was 0.64 ± 0.06, 0.55 ± 0.06, 0.47 ± 0.05 and 0.40 ± 0.04, respectively; p < 0.001 and VD(alv)/VT(alv) 0.53 ± 0.07, 0.40 ± 0.07, 0.29 ± 0.06 and 0.25 ± 0.04, respectively; p < 0.001). After CPB, VD(Bohr)/VT and VD(alv)/VT(alv) reached values similar to baseline (0.37 ± 0.04 and 0.19 ± 0.06, respectively). At constant ventilation the alveolar component of VD(Bohr)/VT increased in proportion to the deficit in lung perfusion. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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