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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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Published in: | Archives of emergency medicine 1992-06, Vol.9 (2), p.169-176 |
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description | 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. |
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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.</description><identifier>ISSN: 0264-4924</identifier><identifier>ISSN: 1472-0205</identifier><identifier>EISSN: 1472-0213</identifier><identifier>DOI: 10.1136/emj.9.2.169</identifier><identifier>PMID: 1326975</identifier><identifier>CODEN: AEMEE4</identifier><language>eng</language><publisher>Oxford: BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</publisher><subject>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</subject><ispartof>Archives of emergency medicine, 1992-06, Vol.9 (2), p.169-176</ispartof><rights>1993 INIST-CNRS</rights><rights>Copyright BMJ Publishing Group LTD Jun 1992</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b502t-4fa54c0599088b70d8bd2278759d716ccfaf5eff67ea72154a22c2bf8cfc07b13</citedby><cites>FETCH-LOGICAL-b502t-4fa54c0599088b70d8bd2278759d716ccfaf5eff67ea72154a22c2bf8cfc07b13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285855/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285855/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4389894$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1326975$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steedman, D J</creatorcontrib><creatorcontrib>Robertson, C E</creatorcontrib><title>Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation</title><title>Archives of emergency medicine</title><addtitle>Arch Emerg Med</addtitle><description>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.</description><subject>Acid-Base Imbalance - etiology</subject><subject>Acidosis, Respiratory - blood</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Arteries</subject><subject>Bicarbonates - blood</subject><subject>Biological and medical sciences</subject><subject>Blood Gas Analysis</subject><subject>Carbon Dioxide - blood</subject><subject>Cardiopulmonary Resuscitation - adverse effects</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Heart Arrest - blood</subject><subject>Heart Arrest - therapy</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Sodium - blood</subject><subject>Sodium Bicarbonate</subject><subject>Veins</subject><issn>0264-4924</issn><issn>1472-0205</issn><issn>1472-0213</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><recordid>eNp9kc9rFDEYhoModa2ePAsBxYvMmp-T5CKUwXaVohf14iFkMsk260yyJjNF_3sju2zVg6cE3oeX5-MF4ClGa4xp-9pNu7VakzVu1T2wwkyQBhFM74MVIi1rmCLsIXhUyg4hSlulzsAZpqRVgq_A1wsbBtib4qC9MXHrCgwRmjy7HMwITRygdXHO9X_rYloK7MeUBjgsOcQttCYPIe2XcUrR5J8wu7IUG2YzhxQfgwfejMU9Ob7n4PPl20_dprn-ePWuu7hueo7I3DBvOLOIK4Wk7AUaZD8QIqTgahC4tdYbz533rXBGEMyZIcSS3kvrLRI9pufgzaF3v_STG46-ep_DVJ10MkH_ncRwo7fpVmMiueS8Frw8FuT0fXFl1lMo1o2jia6erAUlGGEkK_j8H3CXlhzrcRoLgRAjWJJKvTpQNqdSsvMnFYz078V0XUwrTXRdrNLP_rS_Yw8T1fzFMTfFmtFnE20oJ4xRqaRiFWsOWCiz-3GKTf6mW0EF1x--dLrrNnTD3lPd3d3cV5f_-f0Cbme7kg</recordid><startdate>19920601</startdate><enddate>19920601</enddate><creator>Steedman, D J</creator><creator>Robertson, C E</creator><general>BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</general><general>Blackwell</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RQ</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19920601</creationdate><title>Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation</title><author>Steedman, D J ; Robertson, C E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b502t-4fa54c0599088b70d8bd2278759d716ccfaf5eff67ea72154a22c2bf8cfc07b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Acid-Base Imbalance - etiology</topic><topic>Acidosis, Respiratory - blood</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Arteries</topic><topic>Bicarbonates - blood</topic><topic>Biological and medical sciences</topic><topic>Blood Gas Analysis</topic><topic>Carbon Dioxide - blood</topic><topic>Cardiopulmonary Resuscitation - adverse effects</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Heart Arrest - blood</topic><topic>Heart Arrest - therapy</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Sodium - blood</topic><topic>Sodium Bicarbonate</topic><topic>Veins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steedman, D J</creatorcontrib><creatorcontrib>Robertson, C E</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Career & Technical Education Database</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steedman, D J</au><au>Robertson, C E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation</atitle><jtitle>Archives of emergency medicine</jtitle><addtitle>Arch Emerg Med</addtitle><date>1992-06-01</date><risdate>1992</risdate><volume>9</volume><issue>2</issue><spage>169</spage><epage>176</epage><pages>169-176</pages><issn>0264-4924</issn><issn>1472-0205</issn><eissn>1472-0213</eissn><coden>AEMEE4</coden><abstract>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.</abstract><cop>Oxford</cop><pub>BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine</pub><pmid>1326975</pmid><doi>10.1136/emj.9.2.169</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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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 |
title | Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation |
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