Increases in coronary vein CO2 during cardiac resuscitation.
We investigated the aortic, mixed venous, and great cardiac vein acid-base changes in eight domestic pigs during cardiac arrest produced by ventricular fibrillation and during cardiopulmonary resuscitation (CPR). The great cardiac vein PCO2 increased from a control value of 52 +/- 2 to 132 +/- 28 (SD) Torr during CPR, whereas the arterial PCO2 was unchanged (39 +/- 4 vs. 38 +/- 4). The coronary venoarterial PCO2 gradient, therefore, increased remarkably from 13 +/- 2 to 94 +/- 29 Torr. The simultaneously measured great cardiac vein lactate concentrations increased from 0.24 +/- 0.06 to 7.3 +/- 2.34 mmol/l. Much more moderate increases in the lactate content of aortic blood from 0.64 +/- 0.25 to 2.56 +/- 0.27 mmol/l were observed. Increases in great cardiac vein PCO2 and lactate were highly correlated during CPR (r = 0.91). After successful CPR, the coronary venoarterial PCO2 gradient returned to normal levels within 2 min after restoration of spontaneous circulation. Lactate content was rapidly reduced and lactate extraction was reestablished within 30 min after CPR. These studies demonstrate marked but reversible acidosis predominantly as the result of myocardial CO2 production during CPR.
Gudipati
C V
CV
Department of Medicine, University of Health Sciences, Chicago Medical School Illinois 60064.
Weil
M H
MH
Gazmuri
R J
RJ
Deshmukh
H G
HG
Bisera
J
J
Rackow
E C
EC
D000818:Animals; D001011:Aorta; D001769:Blood; D002245:Carbon Dioxide / Q000097:blood*; D003331:Coronary Vessels; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000628:therapy; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D012151:Resuscitation; D013552:Swine; D014680:Veins
D007773:Lactates; D002245:Carbon Dioxide; D019344:Lactic Acid