TY - JOUR AU - Gavelli, Francesco AU - Teboul, Jean-Louis AU - Monnet, Xavier PY - 2019 TI - How can CO 2 -derived indices guide resuscitation in critically ill patients? JF - Journal of Thoracic Disease; Vol 11, Supplement 11 (July 19, 2019): Journal of Thoracic Disease (CO2-Derived Variables for Hemodynamic Management in Critically Ill Patients) Y2 - 2019 KW - N2 - Assessing the adequacy of oxygen delivery with oxygen requirements is one of the key-goal of haemodynamic resuscitation. Clinical examination, lactate and central or mixed venous oxygen saturation (SvO 2 and ScvO 2 , respectively) all have their limitations. Many of them may be overcome by the use of the carbon dioxide (CO 2 )-derived variables. The venoarterial difference in CO 2 tension (“ΔPCO 2 ” or “PCO 2 gap”) is not an indicator of anaerobic metabolism since it is influenced by the oxygen consumption. By contrast, it reliably indicates whether blood flow is sufficient to carry CO 2 from the peripheral tissue to the lungs in view of its clearance: it, thus, reflects the adequacy of cardiac output with the metabolic condition. The ratio of the PCO 2 gap with the arteriovenous difference of oxygen content (PCO 2 gap/Ca-vO 2 ) might be a marker of anaerobiosis. Conversely to SvO 2 and ScvO 2 , it remains interpretable if the oxygen extraction is impaired as it is in case of sepsis. Compared to lactate, it has the main advantage to change without delay and to provide a real-time monitoring of tissue hypoxia. UR - https://jtd.amegroups.org/article/view/30008