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Regional venous-to-arterial carbon dioxide pressure and content differences during endotoxemic shock: influence of hydrogen ion accumulation vs. Haldane effect

par Ospina-Tascón, Gustavo Adolfo;De Backer, Daniel ;Aldana, José J.L.;Marin, Alberto A.F.G.;Calderón, Luis Eduardo;Chica, Julián;García-Gallardo, Gustavo;Orozco, Nicolás;Mallat, Jihad
Référence Intensive care medicine experimental, 13, 1, 93
Publication Publié, 2025-12

Article révisé par les pairs

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Résumé :

Background: The relationship between carbon dioxide pressures (PCO2) and contents (CCO2) is linked to the Haldane effect. Nevertheless, under shock conditions, hydrogen ion accumulation might strongly influence the discrepancies between PCO2 and CCO2. This study aims to evaluate the impact of hydrogen ion accumulation and hemoglobin oxygen saturation (Haldane effect) on PCO2:CCO2 relationships during induction and resuscitation of endotoxemic shock. Methods: Shock was induced by an escalating dose of lipopolysaccharide in 12 female Landrace pigs. Norepinephrine was then started to maintain mean arterial pressure ≥ 75 mmHg, while successive fluid boluses were administered targeting arterial lactate < 2.0 mmol·L−1 or decreases > 10% per 30 min. Mesenteric venous and arterial PCO2 were measured at baseline, time of shock, and then, every hour for 6 h, while their respective CCO2 were computed using the Douglas equation. Mesenteric venous-to-arterial PCO2 and CCO2 differences (i.e., ΔPCO2 and ΔCCO2), and then, their absolute arithmetic differences (i.e., [