• P Kiefer, S Nunes, P Kosonen, and J Takala.
• Department of Anesthesiology, University Clinic Ulm, Prittwitzstrasse 43, 89075 Ulm, Germany. peter.kiefer@medizin.uni-ulm.de
• Intensive Care Med. 2001 Apr 1; 27 (4): 775-8.

ObjectivesTo evaluate the acute effects of an increase in PCO2 on splanchnic tissue perfusion and metabolism.DesignClinical prospective study in the intensive care unit in a university clinic.PatientsSix patients with severe acute lung injury requiring mechanical ventilation. All patients had bilateral infiltrates on chest radiography, a PaO2/FIO2 ratio less than 200 mmHg, and stable hemodynamics without vasoactive drugs.InterventionsPCO2 was increased 5-20% by an added dead space from baseline, followed by a return to baseline.Measurements And ResultsSplanchnic blood flow was measured using primed continuous infusion of indocyanine green dye with hepatic venous sampling and systemic hemodynamics by routine monitoring; we also determined the gastric mucosal-arterial PCO2 difference and splanchnic lactate/pyruvate exchange. PCO2 was increased by an added dead space; after 60 min all measurements were repeated; after return to baseline a third measurement followed. The increase in PCO2 had no significant effect on splanchnic blood flow or indices of perfusion and metabolism.ConclusionOur results suggest that acute moderate changes in PCO2 have no major effect on splanchnic perfusion and metabolism.

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