scholarly journals Cerebral and Systemic Stress Parameters in Correlation with Jugulo-Arterial CO2 Gap as a Marker of Cerebral Perfusion during Carotid Endarterectomy

2021 ◽  
Vol 10 (23) ◽  
pp. 5479
Author(s):  
Zoltán Kovács-Ábrahám ◽  
Timea Aczél ◽  
Gábor Jancsó ◽  
Zoltán Horváth-Szalai ◽  
Lajos Nagy ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Carotid Endarterectomy ◽  
Cerebral Perfusion ◽  
Carbon Dioxide Partial Pressure ◽  
Metabolic Balance ◽  
Blood Samples ◽  
Arterial Blood ◽  
Lactate Levels ◽  
Systemic Stress ◽  
Stress Parameters

Intraoperative stress is common to patients undergoing carotid endarterectomy (CEA); thus, impaired oxygen and metabolic balance may appear. In this study, we aimed to identify new markers of intraoperative cerebral ischemia, with predictive value on postoperative complications during CEA, performed in regional anesthesia. A total of 54 patients with significant carotid stenosis were recruited and submitted to CEA. Jugular and arterial blood samples were taken four times during operation, to measure the jugulo-arterial carbon dioxide partial pressure difference (P(j-a)CO2), and cortisol, S100B, L-arginine, and lactate levels. A positive correlation was found between preoperative cortisol levels and all S100B concentrations. In addition, they are positively correlated with P(j-a)CO2 values. Conversely, postoperative cortisol inversely correlates with P(j-a)CO2 and postoperative S100B values. A negative correlation was observed between maximum systolic and pulse pressures and P(j-a)CO2 after carotid clamp and before the release of clamp. Our data suggest that preoperative cortisol, S100B, L-arginine reflect patients’ frailty, while these parameters postoperatively are influenced by intraoperative stress and injury. As a novelty, P(j-a)CO2 might be an emerging indicator of cerebral blood flow during CEA.

scholarly journals Intraocular pressure and its correlation with blood gas parameters in crested caracaras (Caracara plancus) anesthetized with isoflurane and sevoflurane

2008 ◽  
Vol 60 (6) ◽  
pp. 1461-1467
Author(s):  
A.P. Ribeiro ◽  
S.N. Vitaliano ◽  
R. Thiesen ◽  
A. Escobar ◽  
J.P. Duque Ortiz ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Intraocular Pressure ◽  
Brachial Artery ◽  
Carbon Dioxide Partial Pressure ◽  
Blood Gas ◽  
Blood Samples ◽  
Time Points ◽  
Blood Ph ◽  
Arterial Ph ◽  
Blood Gas Parameters

The intraocular pressure (IOP) and its correlations with arterial carbon dioxide partial pressure (PaCO2) and arterial pH were studied in five crested caracaras (Caracara plancus) anesthetized with isoflurane (ISO) and sevoflurane (SEV). Baseline IOP values were measured in both eyes (M0). Brachial artery was previously catheterized to obtain blood gas and cardiorespiratory analysis. Anesthesia was induced with 5% ISO and maintained with 2.5% for 40 minutes. IOP measurements and blood samples were evaluated in different moments until the end of the procedure. After recovering, a second anesthesia was induced with 6% SEV and maintained with 3.5%. Parameters were evaluated at the same time points of the previous procedure. IOP reduced significantly (P= 0.012) from M0 at all time points and no significative changes were observed between ISO and SEV anesthesias. Correlation between IOP and PaCO2 and between PIO and blood pH were found only for SEV. IOP and blood pH decreased in parallel with IOP, whereas values of PaCO2 increased in caracaras anesthetized with isoflurane and sevoflurane.

A comparison of exercise responses in stairclimbing and cycling

1979 ◽  
Vol 46 (3) ◽  
pp. 510-516 ◽  
Author(s):  
F. A. Oldenburg ◽  
D. W. McCormack ◽  
J. L. Morse ◽  
N. L. Jones
Keyword(s):  
Carbon Dioxide ◽  
Average Power ◽  
Blood Gases ◽  
Normal Subjects ◽  
Cycle Ergometry ◽  
Arterial Blood ◽  
Carbon Dioxide Pressure ◽  
Lactate Levels ◽  
Power Outputs ◽  
Co2 Flow

A free-paced 14.8-m stairclimb was compared to cycle ergometry at equivalent power outputs in six normal subjects. Heart rate (HR), inspiratory flow (VI) andd oxygen saturation in arterial blood (Sao2) were analyzed continuously, carbon dioxide output (Vco2) and oxygen consumption (Vo2) for the duration of exercise, and rebreathing mixed venous carbon dioxide pressure (Pvco2), capillary blood gases, and lactates at the completion of exercise. The average power output was 1,394 kpm/min sustained for 54.8 s. The HR and Vo2 responses were not significantly different between the two forms of exercise. VI was 20.3% less stairclimbing (P smaller than 0.005). A fall in Sao2 of 31.1% +/- 2.7) occurred in stairclimbing compared to 1.2% (+/- 2.1) in cycle ergometry. Differences in Sao2 between stairclimbing and cycling correlated with differences in VI (r = 0.80); falls in Sao2 could be prevented by overbreathing during stairclimbing or induced by controlled underbreathing during cycling. Vco2 and postexercise lactate levels were less stairclimbing (P smaller than 0.005 and P smaller than 0.01), as were Pvco2 measurements. The findings are consistent with a lower CO2 flow to the lung during stairclimbing than in cycling, which results in a lower alveolar ventilation and a consequent fall in Sao2.

An Evaluation of Transcutaneous Carbon Dioxide Partial Pressure Monitoring during Apnea Testing in Brain-dead Patients

2006 ◽  
Vol 104 (4) ◽  
pp. 701-707 ◽  
Author(s):  
Benoîit Vivien ◽  
Frédéric Marmion ◽  
Sabine Roche ◽  
Catherine Devilliers ◽  
Olivier Langeron ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Test Group ◽  
Carbon Dioxide Partial Pressure ◽  
Arterial Oxygen ◽  
Apnea Test ◽  
Transcutaneous Carbon Dioxide ◽  
Arterial Blood ◽  
The Mean ◽  
Brain Dead

Background Diagnosis of brain death usually requires an arterial carbon dioxide partial pressure (Paco2) of 60 mmHg during the apnea test, but the increase in Paco2 is unpredictable. The authors evaluated whether transcutaneous carbon dioxide partial pressure (Ptcco2) monitoring during apnea test can predict that a Paco2 of 60 mmHg has been reached. Methods The authors compared Ptcco2 measured with a transcutaneous ear sensor (V-Sign Sensor, Sentec Digital Monitoring System; SENTEC-AG, Therwil, Switzerland) and Paco2 obtained from arterial blood gas measurements in 32 clinically brain-dead patients. Results In the first 20 patients, the mean Paco2-Ptcco2 gradient was 0.7 +/- 3.6 mmHg at baseline and 8.7 +/- 7.1 mmHg after 20 min of apnea. Using receiver operating characteristic curve analysis (area under the curve: 0.983 +/- 0.013), the best threshold value of Ptcco2 to predict that a Paco2 of 60 mmHg had been reached was 60 mmHg (positive predictive value: 1.00 [0.93-1.00]). In the following 12 patients investigated with use of this Ptcco2 target value of 60 mmHg, the mean duration of the apnea test (11 +/- 4 vs. 20 +/- 0 min; P < 0.001), hypercapnia (74.0 +/- 4.9 vs. 98.3 +/- 20.0 mmHg; P < 0.001), acidosis (pH: 7.18 +/- 0.06 vs. 7.11 +/- 0.08; P < 0.001), and decrease in arterial oxygen partial pressure (-47 +/- 44 vs. -95 +/- 89; P < 0.05) at the end of the test were reduced as compared with the 20-min apnea test group. Conclusion During the apnea test in brain-dead patients, a Ptcco2 of 60 mmHg accurately predicts that a Paco2 of 60 mmHg has been reached. This may allow a reduction in the duration of the apnea test and consecutively limit occurrence of complications.

Normal arterial blood pH, oxygen, and carbon dioxide tensions in unanesthetized dogs

1972 ◽  
Vol 32 (1) ◽  
pp. 152-153 ◽  
Author(s):  
Eric O. Feigl ◽  
Louis G. D'Alecy
Keyword(s):  
Carbon Dioxide ◽  
Rectal Temperature ◽  
Femoral Artery ◽  
Glass Electrode ◽  
Blood Gas ◽  
Blood Samples ◽  
Arterial Blood ◽  
Blood Ph ◽  
Clark Electrode

Femoral artery blood samples from 30 unanesthetized unrestrained nonpanting dogs were analyzed. Average normal pH was 7.42 (sd 0.03), mean Po2 89.5 mm Hg (sd 4.4), and Pco2 36.8 mm Hg (sd 2.4). pH was determined with a glass electrode. Pco2 was measured using a Severinghaus electrode. Po2 was determined with a Clark-type polarographic polypropylene-covered electrode. Measurements were made at 39 C (normal dog rectal temperature). blood gas; Clark electrode; Severinghaus electrode

Temperature-induced changes in blood acid-base status in the alligator, Alligator mississipiensis

1978 ◽  
Vol 45 (6) ◽  
pp. 922-926 ◽  
Author(s):  
D. G. Davies
Keyword(s):  
Carbon Dioxide ◽  
Body Temperature ◽  
Minute Ventilation ◽  
Carbon Dioxide Production ◽  
Carbon Dioxide Partial Pressure ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Body Temperature Increase ◽  
Alligator Mississipiensis

Gas exchange and arterial blood acid-base status were measured in 13 conscious alligators, Alligator mississipiensis, at 15, 25, and 35 degrees C. Arterial pH decreased by 0.250 units (from 7.635 to 7.385) and arterial carbon dioxide partial pressure increased by 11.4 Torr (from 11.8 to 23.2) as body temperature increased from 15 to 35 degrees C. No statistically significant changes occurred in arterial bicarbonate concentration. When OH-/H+ and alpha-imidazole were compared at each temperature, more variability was observed in OH-/H+, which increased from 8.7 to 12.0 as temperature increased from 15 to 35 degrees C. alpha-Imidazole remained essentially constant (0.76 at 15 degrees C and 0.80 at 35 degrees C). Body temperature increase caused marked increases in minute ventilation (VE), oxygen consumption (VO2), and carbon dioxide production (VCO2). The relative changes in these parameters resulted in a decrease in both VE/VO2 and VE/VCO2. The data of the present study are consistent with the concept that poikilotherms regulate their alveolar ventilation with changes in body temperature in order to keep OH-/H+ or alpha-imidazole constant.

Transient influence of end-tidal carbon dioxide tension on the postural restraint in cerebral perfusion

2009 ◽  
Vol 107 (3) ◽  
pp. 816-823 ◽  
Author(s):  
Rogier V. Immink ◽  
Jasper Truijen ◽  
Niels H. Secher ◽  
Johannes J. Van Lieshout
Keyword(s):  
Carbon Dioxide ◽  
Cerebral Perfusion ◽  
Free Breathing ◽  
Carbon Dioxide Tension ◽  
Carbon Dioxide Partial Pressure ◽  
Potential Contribution ◽  
Mean Flow ◽  
Postural Changes ◽  
Head Up Tilt ◽  
End Tidal

In the upright position, cerebral blood flow is reduced, maybe because arterial carbon dioxide partial pressure (PaCO2) decreases. We evaluated the time-dependent influence of a reduction in PaCO2, as indicated by the end-tidal Pco2 tension (PetCO2), on cerebral perfusion during head-up tilt. Mean arterial pressure, cardiac output, middle cerebral artery mean flow velocity (MCA Vmean), and dynamic cerebral autoregulation at supine rest and 70° head-up tilt were determined during free breathing and with PetCO2 clamped to the supine level. The postural changes in central hemodynamic variables were equivalent, and the cerebrovascular autoregulatory capacity was not significantly affected by tilt or by clamping PetCO2. In the first minute of tilt, the decline in MCA Vmean (10 ± 4 vs. 3 ± 4 cm/s; mean ± SE; P < 0.05) and PetCO2 (6.8 ± 4.3 vs. 1.7 ± 1.6 Torr; P < 0.05) was larger during spontaneous breathing than during isocapnic tilt. However, after 2 min in the head-up position, the reduction in MCA Vmean was similar (7 ± 5 vs. 6 ± 3 cm/s), although the spontaneous decline in PetCO2 was maintained ( P < 0.05 vs. isocapnic tilt). These results suggest that the potential contribution of PaCO2 to the postural reduction in MCA Vmean is transient, leaving the mechanisms for the sustained restrain in MCA Vmean to be identified.

scholarly journals Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane

2008 ◽  
Vol 39 (2) ◽  
pp. 453-459
Author(s):  
Andreza Conti-Patara ◽  
Denise Tabacchi Fantoni ◽  
Silvia Renata Gaido Cortopassi
Keyword(s):  
Carbon Dioxide ◽  
Oxygen Saturation ◽  
Partial Pressure ◽  
Normal Sinus Rhythm ◽  
Arterial Oxygen Saturation ◽  
Carbon Dioxide Partial Pressure ◽  
Arterial Oxygen ◽  
T Wave ◽  
Arterial Blood ◽  
St Segment

The purpose of this study was to clarify the degree of influence of anesthetic agents commonly used during anesthesia on the heart conduction systems of geriatric dogs, with or without the presence of electrocardiographic changes in the pre-anesthetic electrocardiogram and also to determine the possible causes of ST-segment and T-wave changes during anesthesia, by monitoring ventilation and oxygenation. 36 geriatric dogs were evaluated. In addition to electrocardiographic evaluation, the pre-anesthetic study included serum levels of urea, creatinine, total protein, albumin and electrolytes. The pre-anesthetic medication consisted of acepromazine (0.05mg kg-1) in association with meperidine (3.0mg kg-1) by IM injection. Anesthesia was induced with propofol (3.0 to 5.0mg kg-1) by IV injection and maintained with isoflurane in 100% oxygen. During the anesthesia, the animals were monitored by continued computerized electrocardiogram. Systemic blood pressure, heart rate, respiratory rate, end-tidal carbon dioxide, partial pressure of carbon dioxide in arterial blood, arterial oxygen saturation, partial pressure of arterial oxygen and oxygen saturation of hemoglobin were closely monitored. During maintenance anesthesia, normal sinus rhythm was more common (78%). ST-segment and T-wave changes during the anesthetic procedure were quite common and were related to hypoventilation. The use of isoflurane did not result in arrhythmia, being therefore a good choice for this type of animal; Electrocardiographic findings of ST-segment and T-wave changes during the maintenance anesthesia were evident in animals with hypercapnia, a disorder that should be promptly corrected with assisted or controlled ventilation to prevent complicated arrhythmias.

Continuous Transcutaneous Gas Monitoring in Adults on Regular Dialysis Treatment

1989 ◽  
Vol 12 (2) ◽  
pp. 103-110 ◽  
Author(s):  
B. Agazia ◽  
L. Guarda ◽  
C. Lombini ◽  
E. Saporiti
Keyword(s):  
Carbon Dioxide ◽  
Continuous Monitoring ◽  
Blood Gas ◽  
Dialysis Treatment ◽  
Blood Samples ◽  
Good Relationship ◽  
Arterial Blood ◽  
Regular Dialysis Treatment ◽  
Gas Measurements ◽  
Normal Adults

We tested a transcutaneous (tc) oxygen (O2) and carbon dioxide (COz) sensor in 15 normal adults and in 20 patients on regular dialysis treatment (RDT). We compared the tc gas values (ptcO2, PtcCO2) with the gas tension values in arterial blood samples (PaO2, PaCO2), in normal adults and in RDT-patients at the end of a 30-min test and six times during RDT. During the test, PtcO2 correlated with PaO2 both in normal adults (r 0.72p<0.01) and in RDT patients (r 0.41 p<0.05). PtcCO2 correlated with PaCO2 (r 0.59 in normal adults and r 0.76 in RDT). During 14 acetate dialyses the changes were expressed as %Δ from time 0. %Δ PaO2 was – 12.7 at 60 min, + 4.8 at 240 min; %Δ PtcO2 – 6.0 at 60 min, + 9.7 at 240 min; %Δ PaCO2 – 17.7 at 240 min, – 1.8 1 h later; %Δ PtcCO2 was – 15.8 at 240 min, – 3.2 1 h later. Both in normal adults and in RDT, patients there was a good relationship between PtcCO2 and PaCO2 values. In normal adults the absolute PtcO2 values were always lower than PaO2 (– 14.4± 10 mmHg); in RDT-patients this difference was more pronounced (– 27.6± 15.1) and is probably attributable to the lower Hb levels (6.7± 1.1 vs 12.4± 1.2). During RDT the pattern was the same between tc and gas tension values. The tc-sensor seems to be useful in continuous monitoring, especially in acetate dialysis and/or in patients suspected of developing hypoxemia, but it cannot replace direct blood gas measurements in arterial blood samples.

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