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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2006 June;72(6):597-604

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Meaning of arterio-venous PCO2 difference in circulatory shock

Lamia B., Monnet X., Teboul J. L.

Unit of Medical Intensive Care Bicetre University Hospital University Paris XI, Paris, France


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The arterovenous difference in carbon dioxide tension (∆PCO2) can be calculated after simultaneous sampling of arterial blood (PaCO2) and of mixed venous blood from the distal of a pulmonary artery catheter (PvCO2). Under physiological conditions, ∆PCO2 ranges from 2 to 5 mmHg. The ∆PCO2 depends on carbon dioxide and cardiac output by a complex fashion. In this article, we detail the influence of these factors on ∆PCO2 in normoxic conditions and in hypoxic conditions. We bring evidence that ∆PCO2 cannot serve as a marker of tissue hypoxia contrary to what was initially thought. However, ∆PCO2 can be considered as a marker of the adequacy of venous blood flow (i.e. cardiac output) to remove the total CO2 produced by the peripheral tissues. In this regard, the knowledge of ∆PCO2 should help the clinicians for the decision of giving therapy aimed at increasing cardiac output.

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