• Journal of critical care · Dec 2018

    Poor agreement in the calculation of venoarterial PCO2 to arteriovenous O2 content difference ratio using central and mixed venous blood samples in septic patients.

    • Arnaldo Dubin, Mario O Pozo, Vanina S Kanoore Edul, Risso Vazquez Alejandro A Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina., and Carolina Enrico.
    • Servicio de Terapia Intensiva, Sanatorio Otamendi y Miroli, Buenos Aires, Argentina; Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900 La Plata, Argentina. Electronic address: arnaldodubin@gmail.com.
    • J Crit Care. 2018 Dec 1; 48: 445-450.

    PurposeCentral venous minus arterial PCO2 to arterial minus central venous O2 content difference ratio (Pcv-aCO2/Ca-cvO2) has been proposed as a clinical surrogate for respiratory quotient. Our goal was to assess its interchangeability with mixed venous minus arterial PCO2 to arterial minus mixed venous O2 content difference ratio (Pmv-aCO2/Ca-mvO2).Materials And MethodsThis is a subanalysis of a previously published study. We studied 23 septic patients who had an indwelling Swan-Ganz catheter. The agreement between Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 was evaluated by Bland and Altman analysis. We also performed linear regression analysis with Pmv-aCO2/Ca-mvO2 as the dependent variable.Results95% limits of agreement between Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were 1.48. Pmv-aCO2/Ca-mvO2 was significantly correlated with hemoglobin and lactate (R2 = 0.48 and 0.31, respectively, P < 0.01 for both).ConclusionsIn this study, Pcv-aCO2/Ca-cvO2 and Pmv-aCO2/Ca-mvO2 were not interchangeable. In addition, Pmv-aCO2/Ca-mvO2 is a composite variable, which depends on several determinants. Values of Pcv-aCO2/Ca-cvO2 should be cautiously interpreted in the assessment of critically ill patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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