دورية أكاديمية
أعرض في EDS

Effects of changes in inspired oxygen fraction on urinary oxygen tension measurements.

التفاصيل البيبلوغرافية
العنوان: Effects of changes in inspired oxygen fraction on urinary oxygen tension measurements.
المؤلفون: Osawa EA; Imed Group Research Department, Sao Paulo, Brazil.; Intensive Care Unit, Hospital Sao Camilo, Unidade Pompeia, Sao Paulo, Brazil.; Department of Intensive Care, Austin Hospital, Melbourne, VIC, 3084, Australia., Cutuli SL; Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Università Cattolica del Sacro Cuore, Rome, Italy., Yanase F; Department of Intensive Care, Austin Hospital, Melbourne, VIC, 3084, Australia.; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia., Iguchi N; Department of Intensive Care, Austin Hospital, Melbourne, VIC, 3084, Australia.; Department of Anaesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.; Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia., Bitker L; Service de Médecine Intensive - Réanimation, Hôpital de La Croix Rousse, Hospices Civils de Lyon, Lyon, France., Maciel AT; Imed Group Research Department, Sao Paulo, Brazil.; Intensive Care Unit, Hospital Sao Camilo, Unidade Pompeia, Sao Paulo, Brazil., Lankadeva YR; Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.; Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia., May CN; Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.; Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia., Evans RG; Pre-Clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia.; Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia., Eastwood GM; Department of Intensive Care, Austin Hospital, Melbourne, VIC, 3084, Australia.; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia., Bellomo R; Department of Intensive Care, Austin Hospital, Melbourne, VIC, 3084, Australia. rinaldo.bellomo@austin.org.au.; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia. rinaldo.bellomo@austin.org.au.; Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia. rinaldo.bellomo@austin.org.au.
المصدر: Intensive care medicine experimental [Intensive Care Med Exp] 2022 Dec 12; Vol. 10 (1), pp. 52. Date of Electronic Publication: 2022 Dec 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag, GmbH Country of Publication: Germany NLM ID: 101645149 Publication Model: Electronic Cited Medium: Print ISSN: 2197-425X (Print) Linking ISSN: 2197425X NLM ISO Abbreviation: Intensive Care Med Exp Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Heidelberg, Germany : Springer-Verlag, GmbH
مستخلص: Background: Continuous measurement of urinary PO 2 (PuO 2 ) is being applied to indirectly monitor renal medullary PO 2 . However, when applied to critically ill patients with shock, its measurement may be affected by changes in FiO 2 and PaO 2 and potential associated O 2 diffusion between urine and ureteric or bladder tissue. We aimed to investigate PuO 2 measurements in septic shock patients with a fiberoptic luminescence optode inserted into the urinary catheter lumen in relation to episodes of FiO 2 change. We also evaluated medullary and urinary oxygen tension values in Merino ewes at two different FiO 2 levels.
Results: In 10 human patients, there were 32 FiO 2 decreases and 31 increases in FiO 2 . Median pre-decrease FiO 2 was 0.36 [0.30, 0.39] and median post-decrease FiO 2 was 0.30 [0.23, 0.30], p = 0.006. PaO 2 levels decreased from 83 mmHg [77, 94] to 72 [62, 80] mmHg, p = 0.009. However, PuO 2 was 23.2 mmHg [20.5, 29.0] before and 24.2 mmHg [20.6, 26.3] after the intervention (p = 0.56). The median pre-increase FiO 2 was 0.30 [0.21, 0.30] and median post-increase FiO 2 was 0.35 [0.30, 0.40], p = 0.008. PaO 2 levels increased from 64 mmHg [58, 72 mmHg] to 71 mmHg [70, 100], p = 0.04. However, PuO 2 was 25.0 mmHg [IQR: 20.7, 26.8] before and 24.3 mmHg [IQR: 20.7, 26.3] after the intervention (p = 0.65). A mixed linear regression model showed a weak correlation between the variation in PaO 2 and the variation in PuO 2 values. In 9 Merino ewes, when comparing oxygen tension levels between FiO 2 of 0.21 and 0.40, medullary values did not differ (25.1 ± 13.4 mmHg vs. 27.9 ± 15.4 mmHg, respectively, p = 0.6766) and this was similar to urinary oxygen values (27.1 ± 6.17 mmHg vs. 29.7 ± 4.41 mmHg, respectively, p = 0.3192).
Conclusions: Changes in FiO 2 and PaO 2 within the context of usual care did not affect PuO 2 . Our findings were supported by experimental data and suggest that PuO 2 can be used as biomarker of medullary oxygenation irrespective of FiO 2 .
(© 2022. The Author(s).)
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فهرسة مساهمة: Keywords: Inspired oxygen fraction; Sepsis; Septic shock; Urinary oxygen tension; Urinary oxygenation
تواريخ الأحداث: Date Created: 20221212 Latest Revision: 20221221
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9742069
DOI: 10.1186/s40635-022-00479-y
PMID: 36504004
قاعدة البيانات: MEDLINE
الوصف
تدمد:2197-425X
DOI:10.1186/s40635-022-00479-y