Establishing a Gradient between Partial Pressure of Arterial Carbon Dioxide and End-Tidal Carbon Dioxide in Patients with Acute Respiratory Distress Syndrome
| Autor: | Raju Mehta, Hesam Keshmiri, Tabassum Hanif, Joy Iskandar, Tariq Yousuf, Daniel Wozniczka, Khansa Ahmad, Taylor Brinton, Ghulam Murtaza |
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| Rok vydání: | 2017 |
| Předmět: |
Male
ARDS medicine.medical_specialty Partial Pressure General Biochemistry Genetics and Molecular Biology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Statistical significance Internal medicine Humans Medicine In patient Respiratory Distress Syndrome Lung business.industry 030208 emergency & critical care medicine Arteries General Medicine Partial pressure Carbon Dioxide Middle Aged medicine.disease Surgery medicine.anatomical_structure Blood pressure 030228 respiratory system chemistry Carbon dioxide Cardiology Arterial blood Female business |
| Zdroj: | Journal of Investigative Medicine. 65:338-341 |
| ISSN: | 1708-8267 1081-5589 |
| DOI: | 10.1136/jim-2016-000253 |
| Popis: | End-tidal carbon dioxide (ETCO2) monitoring is useful in many situations. However, ETCO2 monitoring is unreliable in patients with acute respiratory distress syndrome (ARDS) due to widespread lung inflammation. In our study, we attempt to establish the gradient between the arterial pressure of carbon dioxide (PaCO2) and ETCO2 in patients with ARDS, which we defined as the PaETCO2 gradient. The main objective of the study was to establish a PaETCO2 gradient in each severity of ARDS. We analyzed 35 patients with ARDS and a total of 88 arterial blood gases were included. PaCO2, PaO2/FiO2 and ETCO2 were measured. Patients were stratified into mild, moderate and severe ARDS as classified by the Berlin ARDS criteria. PaCO2 and ETCO2 were compared at each severity stratification. The mean PaCO2 was 50.0, the mean ETCO2 was 26.6 and the gradient among all samples was 23.24 (±12.02). The mean gradient for each severity is as follows: mild: 19.3 (±9.9), moderate: 27.9 (±13.2) and severe: 23.9 (±7.8). The difference between the PaETCO2 gradient of the mild to moderate (p=0.001) and mild to severe groups (p=0.01) reached statistical significance. However, the difference between the moderate to severe groups did not reach statistical significance (p=0.48). We found the gradient between PaCO2 and ETCO2 in patients with ARDS is vast and tends to worsen with increasing severity of ARDS. This indicates that the gradient between the 2 may be used as an indicator of increasing severity of ARDS. |
| Databáze: | OpenAIRE |
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