Factors associated with blood oxygen partial pressure and carbon dioxide partial pressure regulation during respiratory extracorporeal membrane oxygenation support: data from a swine model.
OBJECTIVE
The aim of this study was to explore the factors associated with blood oxygen partial pressure and carbon dioxide partial pressure.


METHODS
The factors associated with oxygen - and carbon dioxide regulation were investigated in an apneic pig model under veno-venous extracorporeal membrane oxygenation support. A predefined sequence of blood and sweep flows was tested.


RESULTS
Oxygenation was mainly associated with extracorporeal membrane oxygenation blood flow (beta coefficient = 0.036mmHg/mL/min), cardiac output (beta coefficient = -11.970mmHg/L/min) and pulmonary shunting (beta coefficient = -0.232mmHg/%). Furthermore, the initial oxygen partial pressure and carbon dioxide partial pressure measurements were also associated with oxygenation, with beta coefficients of 0.160 and 0.442mmHg/mmHg, respectively. Carbon dioxide partial pressure was associated with cardiac output (beta coefficient = 3.578mmHg/L/min), sweep gas flow (beta coefficient = -2.635mmHg/L/min), temperature (beta coefficient = 4.514mmHg/ºC), initial pH (beta coefficient = -66.065mmHg/0.01 unit) and hemoglobin (beta coefficient = 6.635mmHg/g/dL).


CONCLUSIONS
In conclusion, elevations in blood and sweep gas flows in an apneic veno-venous extracorporeal membrane oxygenation model resulted in an increase in oxygen partial pressure and a reduction in carbon dioxide partial pressure 2, respectively. Furthermore, without the possibility of causal inference, oxygen partial pressure was negatively associated with pulmonary shunting and cardiac output, and carbon dioxide partial pressure was positively associated with cardiac output, core temperature and initial hemoglobin.
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Marcelo
M
Park
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Pedro Vitale
PV
Mendes
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Eduardo Leite Vieira
EL
Costa
Unidade de Terapia Intensiva, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Edzangela Vasconcelos Santos
EV
Barbosa
Unidade de Terapia Intensiva, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Adriana Sayuri
AS
Hirota
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brazil.
Luciano Cesar Pontes
LC
Azevedo
D000818:Animals; D001784:Blood Gas Analysis; D001831:Body Temperature / Q000502:physiology; D002245:Carbon Dioxide / Q000378:metabolism*; D002302:Cardiac Output / Q000502:physiology*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006454:Hemoglobins / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism*; D010313:Partial Pressure; D013552:Swine
D006454:Hemoglobins; D002245:Carbon Dioxide; D010100:Oxygen