Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation

Twenty-seven patients in cardiopulmonary arrest had simultaneous measurements of arterial and central venous blood gases during cardiopulmonary resuscitation (CPR) with a pneumatic chest comparison and ventilation device. Mean central venous and arterial hydrogen ion concentrations, PCO2 and calcula...

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Bibliographic Details
Published in:Archives of emergency medicine 1992-06, Vol.9 (2), p.169-176
Main Authors: Steedman, D J, Robertson, C E
Format: Article
Language:English
Subjects:
Acid-Base Imbalance - etiology
Acidosis, Respiratory - blood
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Arteries
Bicarbonates - blood
Biological and medical sciences
Blood Gas Analysis
Carbon Dioxide - blood
Cardiopulmonary Resuscitation - adverse effects
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Female
Heart Arrest - blood
Heart Arrest - therapy
Humans
Hydrogen-Ion Concentration
Intensive care medicine
Male
Medical sciences
Middle Aged
Prospective Studies
Sodium - blood
Sodium Bicarbonate
Veins
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Summary:Twenty-seven patients in cardiopulmonary arrest had simultaneous measurements of arterial and central venous blood gases during cardiopulmonary resuscitation (CPR) with a pneumatic chest comparison and ventilation device. Mean central venous and arterial hydrogen ion concentrations, PCO2 and calculated bicarbonate concentrations were significantly different (P less than 0.01) at all sampling times (0, 10 and 20 min). Central venous blood samples predominantly showed a respiratory acidosis in contrast to a mixed disturbance in arterial samples inclined towards a metabolic acidosis. The mean difference between central venous PCO2 (pcv CO2) and arterial PCO2 (pa CO2) ranged from 5.18 to 5.83 kPa reflecting the low blood flow in patients undergoing CPR. Measurement of arterial Po2 indicated adequate oxygenation using the pneumatic device. Arterial blood gas analysis alone does not reflect tissue acid base status. Bicarbonate administration during CPR may have adverse effects and any decision as to its use should be based on central venous blood gas estimations.
ISSN:0264-4924
1472-0205
1472-0213
DOI:10.1136/emj.9.2.169