Loomba Rohit S, Farias Juan S, Savorgnan Fabio, Acosta Sebastian, Flores Saul, Villarreal Enrique G
Division of Cardiology, Advocate Children's Hospital, Chicago, Illinois, United States.
Department of Pediatrics, Chicago Medical School/Rosalind Franklin University of Medicine and Science, Chicago, Illinois, United States.
J Pediatr Intensive Care. 2022 Feb 28;13(4):372-378. doi: 10.1055/s-0042-1743501. eCollection 2024 Dec.
The assessment of cardiac output and adequacy of systemic oxygen delivery in children after cardiac surgery require the use of an aggregate of hemodynamic monitors and blood tests. There are previously published data regarding the utility of the veno-arterial partial pressure of carbon dioxide difference (AVDco2) to help with this. This study pooled data on the correlation of AVDco2 with other metrics of cardiac output and systemic oxygen delivery such as arteriovenous oxygen saturation difference, venous saturation, and serum lactate. A systematic review of the literature was done to identify studies analyzing the correlation of AVDco2 with other hemodynamic and laboratory values. Data were extracted, and correlation coefficients were pooled for each specific comparison to create a point estimate for the overall correlation. A total of four studies with 350 patients and 809 paired blood gases were pooled. Adequate data were available to assess the correlation of AVDco2 with arteriovenous oxygen saturation difference, venous saturation, and serum lactate. There was a significant, moderate correlation with arteriovenous oxygen saturation difference and venous saturation. A significant, weak correlation with serum lactate was found. The AVDco2 has significant, moderate correlations with other metrics of the adequacy of systemic oxygen delivery such as arteriovenous oxygen saturation difference and venous saturation. There was a significant but only weak correlation with serum lactate. AVDco2 may be complementary to assess the adequacy of cardiac output and systemic oxygen delivery.
评估心脏手术后儿童的心输出量和全身氧输送是否充足，需要综合使用多种血流动力学监测指标和血液检测。此前已有关于静脉 - 动脉二氧化碳分压差值（AVDco2）在这方面作用的文献报道。本研究汇总了关于AVDco2与心输出量和全身氧输送的其他指标（如动静脉血氧饱和度差值、静脉血氧饱和度和血清乳酸）之间相关性的数据。通过对文献进行系统回顾，以确定分析AVDco2与其他血流动力学及实验室指标相关性的研究。提取数据，并对每项具体比较的相关系数进行汇总，以得出总体相关性的点估计值。总共汇总了四项研究，涉及350例患者和809对血气样本。有足够的数据来评估AVDco2与动静脉血氧饱和度差值、静脉血氧饱和度和血清乳酸之间的相关性。AVDco2与动静脉血氧饱和度差值和静脉血氧饱和度存在显著的中度相关性。与血清乳酸存在显著的弱相关性。AVDco2与全身氧输送充足性的其他指标（如动静脉血氧饱和度差值和静脉血氧饱和度）存在显著的中度相关性。与血清乳酸存在显著但较弱的相关性。AVDco2在评估心输出量和全身氧输送是否充足方面可能具有互补作用。
