Tissue perfusion may be assessed at the bedside with ETCO2-derived dead-space estimation

B Fox,J Cohen,P Singer,V Drust

doi:10.1186/cc4698

Abstract

Alveolar dead space is determined by the degree of ventilation/perfusion mismatch in the lung. Since the entire cardiac output must pass through the lungs, we hypothesized that global changes in perfusion would correlate with changes in alveolar dead space. Dead space (VD/VT) can be estimated from the modified Bohr equation, which is further modified by substituting end-tidal CO2 for PECO2 – hence the VDVTest (estimated dead space). We used blood lactate as the endpoint of resuscitation.

Highlights

Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics
Computer-advised insulin infusion in postoperative cardiac surgery patients: a randomized prospective controlled multicenter trial quality the alveoli are observed at an open chest wall under a glass plate representing an artificial situation. To circumvent this restriction we developed a method of intravital endoscopy and tested it on an animal rat model
1Royal Brompton Hospital, London, UK; 2Medical University Graz, observation from mechanical deformation due to the tip of the Austria; 3Charles University Hospital, Prague, Czech Republic; endoscope we developed a flushing catheter that continuously

Summary

Introduction

Tight blood glucose (BG) control has been shown to videos of the alveolar dynamics. The thorax remains intact.decrease morbidity and mortality in critically ill patients [1] but is Results Figure 1 shows a tissue area after lavage of 0.8 mm difficult to achieve using standard insulin infusion protocols. Results Patient characteristics (mean ± SD): age 57.4 ± 15.4 years, 28 female, 52 male, APACHE II score 28.2 ± 6.6; number of organ failures 4.0 ± 1.12; preceding ICU period 8.5 ± 9.3 days; continuous sedation with midazolam 31.2 ± 34.2 mg/hour, fentanyl 0.12 ± 0.08 mg/hour, propofol 45.6 ± 105.2 mg/hour; sedation assessment according to RS 5.65 ± 0.63, CPS 5.15 ± 1.67, CKS 0.65 ± 0.69, CS 9.34 ± 2.13 und LSS 1.78 ± 1.69, RASS –4.50 ± 1.27, FiO2 0.52 ± 0.17, PEEP 8.2 ± 2.4 cmH2O, ventilatory frequency 20.5 ± 4.8/min, pressure control 16.8 ± 4.4 cmH2O, tidal volume 540 ± 115 ml, TVV 2525.6 ± 11,366 ml (minimum 1.52; maximum 91,586). We hypothesized that S100β levels correlate with this tumor’s preoperative characteristics and with perioperative neurological injury despite its supratentorial location and non-neural origin

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Discussion

Conclusion