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Poor agreement in the calculation of venoarterial PCO2 to arteriovenous O2 content difference ratio using central and mixed venous blood samples in septic patients.
J Crit Care. 2018 12; 48:445-450.JC

Abstract

PURPOSE

Central venous minus arterial PCO2 to arterial minus central venous O2 content difference ratio (Pcv-aCO2/Ca-cvO2) has been proposed as a clinical surrogate for respiratory quotient. Our goal was to assess its interchangeability with mixed venous minus arterial PCO2 to arterial minus mixed venous O2 content difference ratio (Pmv-aCO2/Ca-mvO2).

MATERIALS AND METHODS

This is a subanalysis of a previously published study. We studied 23 septic patients who had an indwelling Swan-Ganz catheter. The agreement between Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 was evaluated by Bland and Altman analysis. We also performed linear regression analysis with Pmv-aCO2/Ca-mvO2 as the dependent variable.

RESULTS

95% limits of agreement between Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were 1.48. Pmv-aCO2/Ca-mvO2 was significantly correlated with hemoglobin and lactate (R2 = 0.48 and 0.31, respectively, P < 0.01 for both).

CONCLUSIONS

In this study, Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were not interchangeable. In addition, Pmv-aCO2/Ca-mvO2 is a composite variable, which depends on several determinants. Values of Pcv-aCO2/Ca-cvO2 should be cautiously interpreted in the assessment of critically ill patients.

Authors+Show Affiliations

Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Buenos Aires, Argentina; Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina. Electronic address: arnaldodubin@gmail.com.Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina.Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Buenos Aires, Argentina; Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina.Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina.Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Buenos Aires, Argentina; Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30409351

Citation

Dubin, Arnaldo, et al. "Poor Agreement in the Calculation of Venoarterial PCO2 to Arteriovenous O2 Content Difference Ratio Using Central and Mixed Venous Blood Samples in Septic Patients." Journal of Critical Care, vol. 48, 2018, pp. 445-450.
Dubin A, Pozo MO, Kanoore Edul VS, et al. Poor agreement in the calculation of venoarterial PCO2 to arteriovenous O2 content difference ratio using central and mixed venous blood samples in septic patients. J Crit Care. 2018;48:445-450.
Dubin, A., Pozo, M. O., Kanoore Edul, V. S., Risso Vazquez, A., & Enrico, C. (2018). Poor agreement in the calculation of venoarterial PCO2 to arteriovenous O2 content difference ratio using central and mixed venous blood samples in septic patients. Journal of Critical Care, 48, 445-450. https://doi.org/10.1016/j.jcrc.2018.07.010
Dubin A, et al. Poor Agreement in the Calculation of Venoarterial PCO2 to Arteriovenous O2 Content Difference Ratio Using Central and Mixed Venous Blood Samples in Septic Patients. J Crit Care. 2018;48:445-450. PubMed PMID: 30409351.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Poor agreement in the calculation of venoarterial PCO2 to arteriovenous O2 content difference ratio using central and mixed venous blood samples in septic patients. AU - Dubin,Arnaldo, AU - Pozo,Mario O, AU - Kanoore Edul,Vanina S, AU - Risso Vazquez,Alejandro, AU - Enrico,Carolina, PY - 2018/05/13/received PY - 2018/07/06/revised PY - 2018/07/11/accepted PY - 2018/11/10/entrez PY - 2018/11/10/pubmed PY - 2019/11/19/medline KW - Arteriovenous oxygen content difference KW - Central venous blood KW - Hemoglobin KW - Mixed venous blood KW - Venoarterial PCO(2) SP - 445 EP - 450 JF - Journal of critical care JO - J Crit Care VL - 48 N2 - PURPOSE: Central venous minus arterial PCO2 to arterial minus central venous O2 content difference ratio (Pcv-aCO2/Ca-cvO2) has been proposed as a clinical surrogate for respiratory quotient. Our goal was to assess its interchangeability with mixed venous minus arterial PCO2 to arterial minus mixed venous O2 content difference ratio (Pmv-aCO2/Ca-mvO2). MATERIALS AND METHODS: This is a subanalysis of a previously published study. We studied 23 septic patients who had an indwelling Swan-Ganz catheter. The agreement between Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 was evaluated by Bland and Altman analysis. We also performed linear regression analysis with Pmv-aCO2/Ca-mvO2 as the dependent variable. RESULTS: 95% limits of agreement between Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were 1.48. Pmv-aCO2/Ca-mvO2 was significantly correlated with hemoglobin and lactate (R2 = 0.48 and 0.31, respectively, P < 0.01 for both). CONCLUSIONS: In this study, Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were not interchangeable. In addition, Pmv-aCO2/Ca-mvO2 is a composite variable, which depends on several determinants. Values of Pcv-aCO2/Ca-cvO2 should be cautiously interpreted in the assessment of critically ill patients. SN - 1557-8615 UR - https://www.unboundmedicine.com/medline/citation/30409351/Poor_agreement_in_the_calculation_of_venoarterial_PCO2_to_arteriovenous_O2_content_difference_ratio_using_central_and_mixed_venous_blood_samples_in_septic_patients_ DB - PRIME DP - Unbound Medicine ER -