Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

Franco Díaz, Alejandro Donoso, Cristóbal Carvajal, Tatiana Salomón, María Torres, Benjamín Erranz, Pablo Cruces

Resultado de la investigación: Article

Resumen

Background: Cardiac output (CO) measurement is not a standard of care for critically ill children, but it can be estimated by indirect methods such as veno-arterial pCO 2 difference (ΔVACO 2). Aim: To determine the correlation between CO and ΔVACO 2 and evaluate the usefulness of ΔVACO 2 in the diagnosis of low CO in an experimental pediatric model. Materials and Methods: Thirty piglets weighing 4.8 ± 0.35 kg were anesthetized and monitored with transpulmonary thermodilution. Lung injury was induced with tracheal instillation of Tween 20®. Serial measurements of central venous and arterial blood gases, as well as CO, were obtained at baseline, 1, 2 and 4 h after lung injury induction. Low cardiac output (LCO) was defined as CO lower than 2.5 L/min/m 2. Results: There was an inverse correlation between CO and ΔVACO 2 (r = -0.36, p < 0.01). ΔVACO 2 was 14 ± 8 mmHg in LCO state and 8 ± 6 mmHg when this condition was not present (p < 0.01). Area under the receiver operating characteristic (ROC) curves of ΔVACO 2 and LCO state was 0.78 (0.68-0.86). The best cut-point was 8.9 mmHg to determine LCO with a sensibility 0.78, specificity 0.7, positive predictive value 0.27 and negative predictive value 0.96. Conclusions: In this model there was an inverse correlation between ΔVACO 2 and CO. The best cutoff value to discard LCO was ΔVACO 2 of 8.9 mmHg, indicating that under this value the presence of LCO is very unlikely.

Idioma originalSpanish
Páginas (desde-hasta)39-44
Número de páginas6
PublicaciónRevista Medica de Chile
Volumen140
N.º1
DOI
EstadoPublished - ene 2012

Huella dactilar

Low Cardiac Output
Cardiac Output
Theoretical Models
Pediatrics
Lung Injury
Oil and Gas Fields
Thermodilution
Polysorbates
Standard of Care
Critical Illness
ROC Curve

ASJC Scopus subject areas

  • Medicine(all)

Citar esto

Díaz, Franco ; Donoso, Alejandro ; Carvajal, Cristóbal ; Salomón, Tatiana ; Torres, María ; Erranz, Benjamín ; Cruces, Pablo. / Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental. En: Revista Medica de Chile. 2012 ; Vol. 140, N.º 1. pp. 39-44.
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abstract = "Background: Cardiac output (CO) measurement is not a standard of care for critically ill children, but it can be estimated by indirect methods such as veno-arterial pCO 2 difference (ΔVACO 2). Aim: To determine the correlation between CO and ΔVACO 2 and evaluate the usefulness of ΔVACO 2 in the diagnosis of low CO in an experimental pediatric model. Materials and Methods: Thirty piglets weighing 4.8 ± 0.35 kg were anesthetized and monitored with transpulmonary thermodilution. Lung injury was induced with tracheal instillation of Tween 20{\circledR}. Serial measurements of central venous and arterial blood gases, as well as CO, were obtained at baseline, 1, 2 and 4 h after lung injury induction. Low cardiac output (LCO) was defined as CO lower than 2.5 L/min/m 2. Results: There was an inverse correlation between CO and ΔVACO 2 (r = -0.36, p < 0.01). ΔVACO 2 was 14 ± 8 mmHg in LCO state and 8 ± 6 mmHg when this condition was not present (p < 0.01). Area under the receiver operating characteristic (ROC) curves of ΔVACO 2 and LCO state was 0.78 (0.68-0.86). The best cut-point was 8.9 mmHg to determine LCO with a sensibility 0.78, specificity 0.7, positive predictive value 0.27 and negative predictive value 0.96. Conclusions: In this model there was an inverse correlation between ΔVACO 2 and CO. The best cutoff value to discard LCO was ΔVACO 2 of 8.9 mmHg, indicating that under this value the presence of LCO is very unlikely.",
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year = "2012",
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doi = "10.4067/S0034-98872012000100005",
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Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental. / Díaz, Franco; Donoso, Alejandro; Carvajal, Cristóbal; Salomón, Tatiana; Torres, María; Erranz, Benjamín; Cruces, Pablo.

En: Revista Medica de Chile, Vol. 140, N.º 1, 01.2012, p. 39-44.

Resultado de la investigación: Article

TY - JOUR

T1 - Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

AU - Díaz, Franco

AU - Donoso, Alejandro

AU - Carvajal, Cristóbal

AU - Salomón, Tatiana

AU - Torres, María

AU - Erranz, Benjamín

AU - Cruces, Pablo

PY - 2012/1

Y1 - 2012/1

N2 - Background: Cardiac output (CO) measurement is not a standard of care for critically ill children, but it can be estimated by indirect methods such as veno-arterial pCO 2 difference (ΔVACO 2). Aim: To determine the correlation between CO and ΔVACO 2 and evaluate the usefulness of ΔVACO 2 in the diagnosis of low CO in an experimental pediatric model. Materials and Methods: Thirty piglets weighing 4.8 ± 0.35 kg were anesthetized and monitored with transpulmonary thermodilution. Lung injury was induced with tracheal instillation of Tween 20®. Serial measurements of central venous and arterial blood gases, as well as CO, were obtained at baseline, 1, 2 and 4 h after lung injury induction. Low cardiac output (LCO) was defined as CO lower than 2.5 L/min/m 2. Results: There was an inverse correlation between CO and ΔVACO 2 (r = -0.36, p < 0.01). ΔVACO 2 was 14 ± 8 mmHg in LCO state and 8 ± 6 mmHg when this condition was not present (p < 0.01). Area under the receiver operating characteristic (ROC) curves of ΔVACO 2 and LCO state was 0.78 (0.68-0.86). The best cut-point was 8.9 mmHg to determine LCO with a sensibility 0.78, specificity 0.7, positive predictive value 0.27 and negative predictive value 0.96. Conclusions: In this model there was an inverse correlation between ΔVACO 2 and CO. The best cutoff value to discard LCO was ΔVACO 2 of 8.9 mmHg, indicating that under this value the presence of LCO is very unlikely.

AB - Background: Cardiac output (CO) measurement is not a standard of care for critically ill children, but it can be estimated by indirect methods such as veno-arterial pCO 2 difference (ΔVACO 2). Aim: To determine the correlation between CO and ΔVACO 2 and evaluate the usefulness of ΔVACO 2 in the diagnosis of low CO in an experimental pediatric model. Materials and Methods: Thirty piglets weighing 4.8 ± 0.35 kg were anesthetized and monitored with transpulmonary thermodilution. Lung injury was induced with tracheal instillation of Tween 20®. Serial measurements of central venous and arterial blood gases, as well as CO, were obtained at baseline, 1, 2 and 4 h after lung injury induction. Low cardiac output (LCO) was defined as CO lower than 2.5 L/min/m 2. Results: There was an inverse correlation between CO and ΔVACO 2 (r = -0.36, p < 0.01). ΔVACO 2 was 14 ± 8 mmHg in LCO state and 8 ± 6 mmHg when this condition was not present (p < 0.01). Area under the receiver operating characteristic (ROC) curves of ΔVACO 2 and LCO state was 0.78 (0.68-0.86). The best cut-point was 8.9 mmHg to determine LCO with a sensibility 0.78, specificity 0.7, positive predictive value 0.27 and negative predictive value 0.96. Conclusions: In this model there was an inverse correlation between ΔVACO 2 and CO. The best cutoff value to discard LCO was ΔVACO 2 of 8.9 mmHg, indicating that under this value the presence of LCO is very unlikely.

KW - Blood gas monitoring

KW - Carbon Dioxide

KW - Cardiac Output

KW - Critical Care

KW - Hemodynamics

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