title: Bladder mucosal CO2 compared with gastric mucosal CO2 as a marker for low perfusion states in septic shock.
abstract: Recent reports indicate the possible role of bladder CO(2) as a marker of low perfusion states. To test this hypothesis, shock was induced in six beagle dogs with 1 mg/kg of E. coli lipopolysaccharide, gastric CO(2) (CO(2)-G) was measured with a continuous monitor, and a pulmonary catheter was inserted in the bladder to measure CO(2) (CO(2)-B). Levels of CO(2)-B were found to be lower than those of CO(2)-G, with a mean difference of 36.8 mmHg (P < 0.001), and correlation between both measurements was poor (r(2) = 0.16). Even when the correlation between CO(2)-G and ΔCO(2)-G was narrow (r(2) = 0.86), this was not the case for the relationship between CO(2)-B and ΔCO(2)-B (r(2) = 0.29). Finally, the correlation between CO(2)-G and base deficit was good (r(2) = 0.45), which was not the case with the CO(2)-B correlation (r(2) = 0.03). In our experience, bladder CO(2) does not correlate to hemodynamic parameters and does not substitute gastric CO(2) for detection of low perfusion states.
authors.affiliation: Intensive Care Medicine, University Hospital Carlos Haya, 29010 Málaga, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Seller-Pérez
authors.forename: Manuel E
authors.initials: ME
authors.lastname: Herrera-Gutiérrez
authors.forename: Cesar
authors.initials: C
authors.lastname: Aragón-González
authors.forename: Maria M
authors.initials: MM
authors.lastname: Granados
authors.forename: Juan M
authors.initials: JM
authors.lastname: Dominguez
authors.forename: Rocío
authors.initials: R
authors.lastname: Navarrete
authors.forename: Guillermo
authors.initials: G
authors.lastname: Quesada-García
authors.forename: Juán
authors.initials: J
authors.lastname: Morgaz
authors.forename: Rafael
authors.initials: R
authors.lastname: Gómez-Villamandos
mesh_terms: D000818:Animals; D002245:Carbon Dioxide / Q000378:metabolism*; D004285:Dogs; D005753:Gastric Mucosa / Q000378:metabolism* / Q000503:physiopathology; D006439:Hemodynamics; D008365:Manometry / Q000379:methods; D009092:Mucous Membrane / Q000378:metabolism / Q000503:physiopathology; D010313:Partial Pressure; D010477:Perfusion; D012772:Shock, Septic / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D001743:Urinary Bladder / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D002245:Carbon Dioxide