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Early warning: End-tidal carbon dioxide is associated with central venous oxygenation under continuous cardiorespiratory monitoring in a porcine model of hemorrhagic shock and resuscitation.
American Journal of Surgery 2023 August 20
BACKGROUND: End-tidal carbon dioxide (ETCO2 ) has previously shown promise as a predictor of shock severity and mortality in trauma. ETCO2 monitoring is non-invasive, real-time, and readily available in prehospital settings, but the temporal relationship of ETCO2 to systemic oxygen transport has not been thoroughly investigated in the context of hemorrhagic shock.
METHODS: A validated porcine model of hemorrhagic shock and resuscitation was used in male Yorkshire swine (N = 7). Both ETCO2 and central venous oxygenation (SCV O2 ) were monitored and recorded continuously in addition to other traditional hemodynamic variables.
RESULTS: Linear regression analysis showed that ETCO2 was associated with ScvO2 both throughout the experiment (β = 1.783, 95% confidence interval (CI) [1.552-2.014], p < 0.001) and during the period of most rapid hemorrhage (β = 4.896, 95% CI [2.416-7.377], p < 0.001) when there was a marked decrease in ETCO2 .
CONCLUSIONS: ETCO2 and ScvO2 were closely associated during rapid hemorrhage and continued to be temporally associated throughout shock and resuscitation.
METHODS: A validated porcine model of hemorrhagic shock and resuscitation was used in male Yorkshire swine (N = 7). Both ETCO2 and central venous oxygenation (SCV O2 ) were monitored and recorded continuously in addition to other traditional hemodynamic variables.
RESULTS: Linear regression analysis showed that ETCO2 was associated with ScvO2 both throughout the experiment (β = 1.783, 95% confidence interval (CI) [1.552-2.014], p < 0.001) and during the period of most rapid hemorrhage (β = 4.896, 95% CI [2.416-7.377], p < 0.001) when there was a marked decrease in ETCO2 .
CONCLUSIONS: ETCO2 and ScvO2 were closely associated during rapid hemorrhage and continued to be temporally associated throughout shock and resuscitation.
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