title: Central venous-arterial carbon dioxide difference as an indicator of cardiac index.
abstract: OBJECTIVE
  The mixed venous-arterial (v-a) pCO(2) difference has been shown to be inversely correlated with the cardiac index (CI). A central venous pCO(2), which is easier to obtain, may provide similar information. The purpose of this study was to examine the correlation between the central venous-arterial pCO(2) difference and CI.
  
  
  METHODS
  Prospective, cohort study.
  
  
  METHODS
  Intensive care unit of an urban tertiary care hospital.
  
  
  METHODS
  Eighty-three consecutive intensive care unit patients.
  
  
  METHODS
  Simultaneous blood gases from the arterial, pulmonary artery (PA), and central venous (CV) catheters were obtained. At the same time point, cardiac indices were measured by the thermodilution technique (an average of three measurements). The cardiac indices obtained by the venous-arterial differences were compared with those determined by thermodilution.
  
  
  RESULTS
  The correlation (R(2)) between the mixed venous-arterial pCO(2) difference and cardiac index was 0.903 (p <0.0001), and the correlation between the central venous-arterial pCO(2) difference and cardiac index was 0.892 (p <0.0001). The regression equations for these relationships were natural log (CI)=1.837-0.159 (v-a) CO(2) for the PA and natural log (CI)=1.787-0.151 (v-a) CO(2) for the CV (p <0.0001 for both). The root-mean-squared error for the PA and CV regression equations were 0.095 and 0.101, respectively.
  
  
  CONCLUSIONS
  Venous-arterial pCO(2) differences obtained from both the PA and CV circulations inversely correlate with the cardiac index. Substitution of a central for a mixed venous-arterial pCO(2) difference provides an accurate alternative method for calculation of cardiac output.
authors.affiliation: Department of Surgery, Henry Ford Health Systems, Detroit, MI, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cuschieri
authors.forename: Emanuel P
authors.initials: EP
authors.lastname: Rivers
authors.forename: Michael W
authors.initials: MW
authors.lastname: Donnino
authors.forename: Marius
authors.initials: M
authors.lastname: Katilius
authors.forename: Gordon
authors.initials: G
authors.lastname: Jacobsen
authors.forename: H Bryant
authors.initials: HB
authors.lastname: Nguyen
authors.forename: Nikolai
authors.initials: N
authors.lastname: Pamukov
authors.forename: H Mathilda
authors.initials: HM
authors.lastname: Horst
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001784:Blood Gas Analysis / Q000379:methods*; D002245:Carbon Dioxide / Q000097:blood; D002302:Cardiac Output; D002405:Catheterization, Central Venous; D002407:Catheterization, Swan-Ganz; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010313:Partial Pressure; D011446:Prospective Studies
chemical_list: D002245:Carbon Dioxide