Comparison of two methods to assess blood CO2 equilibration curve in mechanically ventilated patients.

ABSTRACT

In order to compare two mathematical methods to assess the blood CO2 equilibration curve from a single blood gas analysis [Loeppky, J.A., Luft, U.C., Fletcher, E.R., 1983. Quantitative description of whole blood CO2 dissociation curve and Haldane effect. Resp. Physiol. 51, 167-181; Giovannini, I., Chiarla, C., Boldrini, G., Castagneto, M., 1993. Calculation of venoarterial CO2 concentration difference. J. Appl. Physiol. 74, 959-964], arterial and central venous blood gas analyses and oximetry were performed before and after ventilatory resetting, at constant arterial O2 saturation, in 12 mechanically ventilated patients. CO2 equilibration curves obtained from basal arterial blood gas analyses were used to predict arterial CO2 content after ventilatory resetting and vice versa. Internal consistency was very good for both methods and comparable. Method 2 also yielded excellent predictions of changes of arterial pH associated with ventilatory resetting. In determining Haldane effect, method 2 yielded very stable results within the expected range of values, while method 1 yielded a wider spread of results. Method 2 appeared more suitable to determine the Haldane effect in the conditions of the study, probably due to an approach minimizing the effect of potential sources of inaccuracy.