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Zhao B, Yao P, Wei Q, Bianchi TS, Watts EG, Wang B, Yu Z. Effects of seasonal deposition-erosion cycle on sedimentary organic carbon remineralization and oxygen consumption in a large-river delta-front estuary. Sci Total Environ 2024; 916:170377. [PMID: 38280579 DOI: 10.1016/j.scitotenv.2024.170377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 01/29/2024]
Abstract
Seasonal sediment deposition-erosion events are dominant drivers of particle-solute dynamics in large-river delta-front estuaries (LDEs), but their influence on elemental cycles is not yet fully understood. To better constrain the role of deposition-erosion events on elemental cycling in LDEs, benthic fluxes of dissolved inorganic carbon (DIC), oxygen, and pore-water solute profiles were measured over different seasons in the Changjiang LDE. Benthic DIC efflux (23.4 ± 6.0 mmol C m-2 d-1) was greater than oxygen influx (7.5 ± 2.0 mmol O2 m-2 d-1) in summer but less in winter (7.7 ± 1.2 mmol C m-2 d-1 and 10.1 ± 1.5 mmol O2 m-2 d-1, respectively). The additional oxygen consumption in sediments in winter was likely due to the oxidation of inorganic diagenetic reductive products (IDRP) (e.g., NH4+, Fe2+, and Mn2+) in deeper sediments exposed by erosion, which resulted in the development of an "oxygen debt". Sedimentary oxygen respiration accounted for at least 48 % of total oxygen consumption (oxygen consumption in both water column and sediment) in winter and was significantly greater than in summer (∼15 %); this highlighted the importance of winter sediment erosion in oxygen depletion. In addition to IDRP oxidation, the remineralization of resuspended sedimentary organic carbon in water column also contributed to the oxygen consumption. The global dataset on benthic DIC and oxygen fluxes provides evidence that the "oxygen debt" is likely to be widespread in LDEs, exerting a significant impact on global carbon and oxygen cycling.
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Affiliation(s)
- Bin Zhao
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China; Frontiers Science Center for Deep Ocean Multispheres and Earth System, Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education, Ocean University of China, Qingdao 266100, China; Laboratory for Marine Ecology and Environmental Science, Laoshan Laboratory, Qingdao 266237, China
| | - Peng Yao
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education, Ocean University of China, Qingdao 266100, China; Laboratory for Marine Ecology and Environmental Science, Laoshan Laboratory, Qingdao 266237, China.
| | - Qinsheng Wei
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China; Laboratory for Marine Ecology and Environmental Science, Laoshan Laboratory, Qingdao 266237, China
| | - Thomas S Bianchi
- Department of Geological Sciences, University of Florida, Gainesville, FL 32611, USA
| | - Emily G Watts
- Department of Geological Sciences, University of Florida, Gainesville, FL 32611, USA
| | - Baodong Wang
- Key Laboratory of Marine Eco-Environmental Science and Technology, First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China; Laboratory for Marine Ecology and Environmental Science, Laoshan Laboratory, Qingdao 266237, China
| | - Zhigang Yu
- Frontiers Science Center for Deep Ocean Multispheres and Earth System, Key Laboratory of Marine Chemistry Theory and Technology, Ministry of Education, Ocean University of China, Qingdao 266100, China; Laboratory for Marine Ecology and Environmental Science, Laoshan Laboratory, Qingdao 266237, China
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Michel PG, Claudia PH, Andrea RS, Maria DA, Henry RA. Oxygen debt as a predictor of high-flow nasal cannula therapy failure in SARS-CoV-2 patients with acute respiratory failure: A retrospective cohort study. Heart Lung 2024; 64:176-181. [PMID: 38278127 DOI: 10.1016/j.hrtlng.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/20/2023] [Accepted: 10/23/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is known for its rapid progression to acute hypoxemic respiratory failure (AHRF). The increased use of oxygen therapy during the pandemic and the progression of AHRF have highlighted the need to promptly determine the need for orotracheal intubation (OTI). OBJETIVE To determine the validity of quantitative measurement of oxygen debt (DEOx) according to arterial gases compared to the use of iROX in patients with high-flow nasal cannula (HFNC) therapy requirement, presenting with acute respiratory failure as a consequence of SARS-CoV-2 infection. In addition, we aimed to identify the factors associated with the need for orotracheal intubation (OTI). METHODS A retrospective observational cohort study of a database collected from patients with SARS-CoV-2 infection admitted to intensive care units with AHRF and had received HFNC upon admission during the Covid-19 pandemic (March 23, 2020 through August 02, 2021). The variables of interest were factors determining the predictive ability of DEOx and iROX. We used a multiple logarithmic regression model to correct for confounding and mixed-effects variables, and validated for OTI in patients treated with HFNC. RESULTS From a total of 373 patients treated with HFNC, 317 patients (84.9%) required invasive mechanical ventilation. APACHE II (AOR 1.44; 95% CI: 1.14-1.83, p 0,032), vasopressor use (AOR 27.7; 95% CI: 1.83 - 420,63, p 0,017), and DEOx (AOR 1.26; 95% CI: 1.10 - 1.44, p 0,001) were associated with the need for intubation. The predictive model between iROX and DEOx evidenced an AUC of 0.535 vs. 0.606, respectively, with a DEOx cut off point of 7.14 (±10.16, p < 0.01). DEOx as an independent factor of OTI presents an OR 2,48 with cut point 4.5 mlO2/kg (AUC 0.780, CI 95%, 0.753 - 0.808, p < 0.01). CONCLUSIONS DEOx is a valuable measurment to identify the need for OTI in patients with SARS-CoV-2 who were under management with HFNC with a predictive value superior to iROX, being a reproducible and valid quantitative method for the need OTI that can be implemented in other critically illconditions. Further studies are required to characterize the usefulness of DEOx more precisely.
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Affiliation(s)
- Perez-Garzon Michel
- Critical Medicine and Intensive Care, Fundación Clínica Shaio, Bogota DC, Colombia; Msc Mechanical Ventilation and Respiratory Support, Department of Investigation, Fundación Clínica Shaio, Bogota DC, Colombia; Msc Clinical Epidemiology, Department of Intensive Care and Research, Fundación Clínica Shaio, Bogota DC, Colombia.
| | - Poveda-Henao Claudia
- Critical Medicine and Intensive Care, Fundación Clínica Shaio, Bogota DC, Colombia; Msc Mechanical Ventilation and Respiratory Support, Department of Investigation, Fundación Clínica Shaio, Bogota DC, Colombia; Clinical Cardiology, Intensive Care Department, Fundación Clínica Shaio, Bogota DC, Colombia
| | - Rozo-Salinas Andrea
- Critical Medicine and Intensive Care, Fundación Clínica Shaio, Bogota DC, Colombia
| | - Diaz-Ardila Maria
- Physiotherapist, Clinical Epidemiology, Physiotherapy Department, Fundación Clínica Shaio, Bogotá DC, Colombia
| | - Robayo-Amortegui Henry
- Critical Care Resident, Department of Medicine, Universidad de La Sabana, Chia Cundinamarca, Colombia
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Borrelli M, Shokohyar S, Rampichini S, Bruseghini P, Doria C, Limonta EG, Ferretti G, Esposito F. Energetics of sinusoidal exercise below and across critical power and the effects of fatigue. Eur J Appl Physiol 2024:10.1007/s00421-023-05410-1. [PMID: 38242972 DOI: 10.1007/s00421-023-05410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/23/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE Previous studies investigating sinusoidal exercise were not devoted to an analysis of its energetics and of the effects of fatigue. We aimed to determine the contribution of aerobic and anaerobic lactic metabolism to the energy balance and investigate the fatigue effects on the cardiorespiratory and metabolic responses to sinusoidal protocols, across and below critical power (CP). METHODS Eight males (26.6 ± 6.2 years; 75.6 ± 8.7 kg; maximum oxygen uptake 52.8 ± 7.9 ml·min-1·kg-1; CP 218 ± 13 W) underwent exhausting sinusoidal cycloergometric exercises, with sinusoid midpoint (MP) at CP (CPex) and 50 W below CP (CP-50ex). Sinusoid amplitude (AMP) and period were 50 W and 4 min, respectively. MP, AMP, and time-delay (tD) between mechanical and metabolic signals of expiratory ventilation ([Formula: see text]), oxygen uptake ([Formula: see text]), and heart rate ([Formula: see text]) were assessed sinusoid-by-sinusoid. Blood lactate ([La-]) and rate of perceived exertion (RPE) were determined at each sinusoid. RESULTS [Formula: see text] AMP was 304 ± 11 and 488 ± 36 ml·min-1 in CPex and CP-50ex, respectively. Asymmetries between rising and declining sinusoid phases occurred in CPex (36.1 ± 7.7 vs. 41.4 ± 9.7 s for [Formula: see text] tD up and tD down, respectively; P < 0.01), with unchanged tDs. [Formula: see text] MP and RPE increased progressively during CPex. [La-] increased by 2.1 mM in CPex but remained stable during CP-50ex. Anaerobic contribution was larger in CPex than CP-50ex. CONCLUSION The lower aerobic component during CPex than CP-50ex associated with lactate accumulation explained lower [Formula: see text] AMP in CPex. The asymmetries in CPex suggest progressive decline of muscle phosphocreatine concentration, leading to fatigue, as witnessed by RPE.
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Affiliation(s)
- Marta Borrelli
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy
| | - Sheida Shokohyar
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy
| | - Susanna Rampichini
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy.
| | - Paolo Bruseghini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Christian Doria
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy
| | - Eloisa Guglielmina Limonta
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy
- IRCCS Ospedale Galeazzi - Sant'Ambrogio, Via Cristina Belgioioso, 173, 20157, Milan, Italy
| | - Guido Ferretti
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy
- IRCCS Ospedale Galeazzi - Sant'Ambrogio, Via Cristina Belgioioso, 173, 20157, Milan, Italy
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Dyer WB, Simonova G, Chiaretti S, Bouquet M, Wellburn R, Heinsar S, Ainola C, Wildi K, Sato K, Livingstone S, Suen JY, Irving DO, Tung JP, Li Bassi G, Fraser JF. Recovery of organ-specific tissue oxygen delivery at restrictive transfusion thresholds after fluid treatment in ovine haemorrhagic shock. Intensive Care Med Exp 2022; 10:12. [PMID: 35377109 PMCID: PMC8980119 DOI: 10.1186/s40635-022-00439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Fluid resuscitation is the standard treatment to restore circulating blood volume and pressure after massive haemorrhage and shock. Packed red blood cells (PRBC) are transfused to restore haemoglobin levels. Restoration of microcirculatory flow and tissue oxygen delivery is critical for organ and patient survival, but these parameters are infrequently measured. Patient Blood Management is a multidisciplinary approach to manage and conserve a patient’s own blood, directing treatment options based on broad clinical assessment beyond haemoglobin alone, for which tissue perfusion and oxygenation could be useful. Our aim was to assess utility of non-invasive tissue-specific measures to compare PRBC transfusion with novel crystalloid treatments for haemorrhagic shock. Methods A model of severe haemorrhagic shock was developed in an intensive care setting, with controlled haemorrhage in sheep according to pressure (mean arterial pressure 30–40 mmHg) and oxygen debt (lactate > 4 mM) targets. We compared PRBC transfusion to fluid resuscitation with either PlasmaLyte or a novel crystalloid. Efficacy was assessed according to recovery of haemodynamic parameters and non-invasive measures of sublingual microcirculatory flow, regional tissue oxygen saturation, repayment of oxygen debt (arterial lactate), and a panel of inflammatory and organ function markers. Invasive measurements of tissue perfusion, oxygen tension and lactate levels were performed in brain, kidney, liver, and skeletal muscle. Outcomes were assessed during 4 h treatment and post-mortem, and analysed by one- and two-way ANOVA. Results Each treatment restored haemodynamic and tissue oxygen delivery parameters equivalently (p > 0.05), despite haemodilution after crystalloid infusion to haemoglobin concentrations below 70 g/L (p < 0.001). Recovery of vital organ-specific perfusion and oxygen tension commenced shortly before non-invasive measures improved. Lactate declined in all tissues and correlated with arterial lactate levels (p < 0.0001). The novel crystalloid supported rapid peripheral vasodilation (p = 0.014) and tended to achieve tissue oxygen delivery targets earlier. PRBC supported earlier renal oxygen delivery (p = 0.012) but delayed peripheral perfusion (p = 0.034). Conclusions Crystalloids supported vital organ oxygen delivery after massive haemorrhage, despite haemodilution to < 70 g/L, confirming that restrictive transfusion thresholds are appropriate to support oxygen delivery. Non-invasive tissue perfusion and oximetry technologies merit further clinical appraisal to guide treatment for massive haemorrhage in the context of Patient Blood Management. Supplementary Information The online version contains supplementary material available at 10.1186/s40635-022-00439-6.
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Affiliation(s)
- Wayne B Dyer
- Australian Red Cross Lifeblood, Sydney, Australia.
| | - Gabriela Simonova
- Australian Red Cross Lifeblood, Brisbane, Australia.,Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | | | - Mahe Bouquet
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | | | - Silver Heinsar
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | - Carmen Ainola
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | - Karin Wildi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Cardiovascular Research Institute, Basel, Switzerland
| | - Kei Sato
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia
| | | | - Jacky Y Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - David O Irving
- Australian Red Cross Lifeblood, Sydney, Australia.,Faculty of Health, University of Technology, Sydney, Australia
| | - John-Paul Tung
- Australian Red Cross Lifeblood, Brisbane, Australia.,Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Gianluigi Li Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Medical Engineering Research Facility, Queensland University of Technology, Brisbane, Australia.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia
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5
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Laroche D, Mangin M, Besson D, Naaim A, Gouteron A, Casillas JM. Number of raised steps: A tool to assess brief and intense effort involving anaerobic metabolism. Ann Phys Rehabil Med 2018; 61:156-163. [PMID: 29471056 DOI: 10.1016/j.rehab.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/02/2017] [Accepted: 12/12/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the initial anaerobic component of exercise adaptation is unavoidable, no specific functional test is available for use in routine non-sporting practice to evaluate it. OBJECTIVE To assess the bioenergetic and biomechanical properties of the Short and Fast Step Test (SFST), which consists of walking up and down a step as many times as possible in 1minute and to analyse its ability to explore the initial anaerobic component of effort in comparison to a reference self-paced step test. METHODS Overall, 31 healthy subjects (19 women; mean [SD] age, 32.4 [10.2] years) completed a test-retest of a self-paced step test and the SFST, with pre- and post-test measurement of blood lactate concentration and continuous recording of VO2 and modelling of excess post-exercise oxygen consumption (EPOC), near-infrared spectroscopy (NIRS) of the quadriceps and mechanical power (estimated by the number of steps climbed and 3-D motion analysis). RESULTS Both step tests were well tolerated. The reliability of the bioenergetics parameters, number of raised steps, mechanical power and NIRS tissue saturation index was good. Indirect mechanical power (estimated from number of steps) was correlated with direct power (computed from the centre of mass). Lactate accumulation was significantly increased during exercise with only the SFST (mean [SD] increase, 3.86 [3.26]mmolL-1 from resting values, P<0.05). EPOC was higher with the SFST than the self-paced step test (P<0.05). Only the SFST showed significant correlations between number of steps climbed and EPOC (r=0.84; P<0.001) and decreased tissue saturation index (NIRS) and EPOC area (r=-0.39; P<0.05). CONCLUSIONS SFST is feasible, well tolerated, reliable and responsive to explore a brief exercise involving anaerobic metabolism at submaximal intensity. The number of steps taken in 1minute seems a suitable parameter for practical application.
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Affiliation(s)
- Davy Laroche
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France; INSERM U1093, Cognition, Action, Plasticité Sensori-motrice, 21000 Dijon, France
| | - Morgane Mangin
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Delphine Besson
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Alexandre Naaim
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Anaïs Gouteron
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France
| | - Jean-Marie Casillas
- CIC INSERM 1432, Plateforme d'Investigation Technologique, CHU de Dijon, 21000 Dijon, France; INSERM U1093, Cognition, Action, Plasticité Sensori-motrice, 21000 Dijon, France.
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Fahlman A, van der Hoop J, Moore MJ, Levine G, Rocho-Levine J, Brodsky M. Estimating energetics in cetaceans from respiratory frequency: why we need to understand physiology. Biol Open 2016; 5:436-42. [PMID: 26988759 PMCID: PMC4890674 DOI: 10.1242/bio.017251] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The accurate estimation of field metabolic rates (FMR) in wild animals is a key component of bioenergetic models, and is important for understanding the routine limitations for survival as well as individual responses to disturbances or environmental changes. Several methods have been used to estimate FMR, including accelerometer-derived activity budgets, isotope dilution techniques, and proxies from heart rate. Counting the number of breaths is another method used to assess FMR in cetaceans, which is attractive in its simplicity and the ability to measure respiration frequency from visual cues or data loggers. This method hinges on the assumption that over time a constant tidal volume (VT) and O2 exchange fraction (ΔO2) can be used to predict FMR. To test whether this method of estimating FMR is valid, we measured breath-by-breath tidal volumes and expired O2 levels of bottlenose dolphins, and computed the O2 consumption rate (V̇O2) before and after a pre-determined duration of exercise. The measured V̇O2 was compared with three methods to estimate FMR. Each method to estimate V̇O2 included variable VT and/or ΔO2. Two assumption-based methods overestimated V̇O2 by 216-501%. Once the temporal changes in cardio-respiratory physiology, such as variation in VT and ΔO2, were taken into account, pre-exercise resting V̇O2 was predicted to within 2%, and post-exercise V̇O2 was overestimated by 12%. Our data show that a better understanding of cardiorespiratory physiology significantly improves the ability to estimate metabolic rate from respiratory frequency, and further emphasizes the importance of eco-physiology for conservation management efforts. Summary: Accounting for changes in tidal volume and gas exchange improves the ability to estimate field metabolic rate from respiratory frequency in cetaceans.
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Affiliation(s)
- A Fahlman
- Texas A&M University - Corpus Christi, 6300 Ocean Drive, Corpus Christi, TX 78412, USA Oceanográfic, Research Department , Carrer Eduardo Primo Yúfera 1B, Valencia 46012, Spain
| | - J van der Hoop
- Massachusetts Institute of Technology - Woods Hole Oceanographic Institution Joint Program in Oceanography, 77 Massachusetts Ave, Cambridge, MA 02139, USA Biology Department, Woods Hole Oceanographic Institution, 266 Woods Hole Rd, Woods Hole, MA 02543, USA
| | - M J Moore
- Biology Department, Woods Hole Oceanographic Institution, 266 Woods Hole Rd, Woods Hole, MA 02543, USA
| | - G Levine
- Dolphin Quest, Oahu, 5000 Kahala Ave, Honolulu, HI 96816, USA
| | - J Rocho-Levine
- Dolphin Quest, Oahu, 5000 Kahala Ave, Honolulu, HI 96816, USA
| | - M Brodsky
- V.M.D. Consulting, Miami, FL 33138, USA
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He HW, Liu DW, Long Y, Wang XT. High central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio is associated with poor lactate clearance in septic patients after resuscitation. J Crit Care 2015; 31:76-81. [PMID: 26640138 DOI: 10.1016/j.jcrc.2015.10.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/23/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Recently, the central venoarterial carbon dioxide difference/arterial-central venous oxygen difference (P(v-a)CO2/C(a-v)O2) ratio has been suggested as an additional indicator of anaerobic metabolism. We investigated the relationship between the P(v-a)CO2/C(a-v)O2 ratio and 8-hour lactate clearance (LC) in septic patients after resuscitation. METHODS AND RESULTS We prospectively obtained 168 sets of measurements from 84 septic patients. The arterial and central venous blood gases were measured simultaneously at enrollment and 8 hours after resuscitation. The P(v-a)CO2/C(a-v)O2 (r = -0.24, P = .028) at T8 was negatively correlated with 8-hour LC after resuscitation in all patients. The patients with 8-hour LC ≥ 10% exhibited significantly lower P(v-a)CO2/C(a-v)O2 ratios and intensive care unit mortality after resuscitation than the patients with 8-hour LC < 10%. The area under the receiver operating characteristic curve of the P(v-a)CO2/C(a-v)O2 ratio for the detection of LC ≥ 10% was the greatest and was significantly better than that of the central venous oxygen saturation and similar to that of the P(v-a)CO2. Moreover, a P(v-a)CO2/C(a-v)O2 < 1.23 at T8 is related to poor 8-hour LC rate (LC ≥ 10%) in the patients with normalized central venous oxygen saturation values (≥70%) after resuscitation. CONCLUSIONS The high P(v-a)CO2/C(a-v)O2 ratio is associated with poor LC after resuscitation. The P(v-a)CO2/C(a-v)O2 ratio may provide useful information for assessing the LC potential and optimizing the LC rate.
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Affiliation(s)
- Huai-wu He
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Da-wei Liu
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
| | - Yun Long
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Xiao-ting Wang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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Fukui M, Hatanaka T, Yoshioka M, Yan T, Shime N, Tanaka Y. Changes of oxygen transport variables and serum lactate during open-chest cardiac massage in dogs. J Anesth 1994; 8:72-77. [PMID: 28921204 DOI: 10.1007/bf02482759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/1992] [Accepted: 04/08/1993] [Indexed: 12/01/2022]
Abstract
The aim of this study was to investigate the influence of critically low cardiac output (CO) upon oxygen transport. We especially focused on the changes of mixed venous oxygen saturation (S-vO2) in the presence of oxygen consumption ([Formula: see text]) debts. Additionally, we examined the correlation between the cumulative oxygen deficit (Def[Formula: see text]) and serum lactate. Def[Formula: see text] was calculated as the integrated area under the tissue[Formula: see text]) deficit (baseline[Formula: see text]-acutal[Formula: see text]) and time curve. To produce severe low CO, we performed openchest cardiopulmonary resuscitation (CPR) in 11 anesthetized dogs for 1 h. We made the measurements before (baseline values) and during the CPR at 10-min intervals. Supplydependent[Formula: see text] was observed when CO decreased below 40 ml·min-1·kg-1. The mean value of S-vO2 in the range of supply-dependent[Formula: see text] was 13±2% and did not change significantly during 1 h of CPR. The changes of lactate from baseline values were linearly correlated with Def[Formula: see text] (r=0.62,P<0.01), but absolute values of serum lactate were not.
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Affiliation(s)
- Michihiko Fukui
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamikyo-ku, 602, Kyoto, Japan
| | - Tetsuo Hatanaka
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamikyo-ku, 602, Kyoto, Japan
| | - Masami Yoshioka
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamikyo-ku, 602, Kyoto, Japan
| | - Tsutomu Yan
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamikyo-ku, 602, Kyoto, Japan
| | - Nobuaki Shime
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamikyo-ku, 602, Kyoto, Japan
| | - Yoshifumi Tanaka
- Department of Anesthesiology, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamikyo-ku, 602, Kyoto, Japan
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