Pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest
| Autor: | Paolo Pelosi, Wojciech Dąbrowski, Marcus J. Schultz, Chiara Robba, Chloe C. A. Grim, Andras Sikter, Dorota Siwicka-Gieroba, Denise Battaglini, Patricia Rm Rocco, Evert de Jonge |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Resuscitation medicine.medical_treatment Gas exchanges Review 030204 cardiovascular system & hematology Intracellular acidosis Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Hypocapnia Internal medicine medicine Respiratory system Mechanical ventilation business.industry lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine Ventilator targets lcsh:RC86-88.9 Hypothermia medicine.disease Cardiac arrest Cerebral blood flow Cardiology Catecholamine Arterial blood medicine.symptom business Hypercapnia |
| Zdroj: | Intensive Care Medicine Experimental, Vol 8, Iss S1, Pp 1-13 (2020) Intensive Care Medicine Experimental |
| Popis: | Post cardiac arrest syndrome is associated with high morbidity and mortality, which is related not only to a poor neurological outcome but also to respiratory and cardiovascular dysfunctions. The control of gas exchange, and in particular oxygenation and carbon dioxide levels, is fundamental in mechanically ventilated patients after resuscitation, as arterial blood gases derangement might have important effects on the cerebral blood flow and systemic physiology.In particular, the pathophysiological role of carbon dioxide (CO2) levels is strongly underestimated, as its alterations quickly affect also the changes of intracellular pH, and consequently influence metabolic energy and oxygen demand. Hypo/hypercapnia, as well as mechanical ventilation during and after resuscitation, can affect CO2 levels and trigger a dangerous pathophysiological vicious circle related to the relationship between pH, cellular demand, and catecholamine levels. The developing hypocapnia can nullify the beneficial effects of the hypothermia. The aim of this review was to describe the pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest.According to our findings, the optimal ventilator strategies in post cardiac arrest patients are not fully understood, and oxygen and carbon dioxide targets should take in consideration a complex pattern of pathophysiological factors. Further studies are warranted to define the optimal settings of mechanical ventilation in patients after cardiac arrest. |
| Databáze: | OpenAIRE |
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