Monitoring CO2 kinetics as a marker of cardiopulmonary efficiency.

IF 3.5 3区 医学 Q1 CRITICAL CARE MEDICINE Current Opinion in Critical Care Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI:10.1097/MCC.0000000000001156
Fernando Suarez Sipmann, Juan Antonio Sanchez Giralt, Gerardo Tusman
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Abstract

Purpose of review: To describe current and near future developments and applications of CO2 kinetics in clinical respiratory and cardiovascular monitoring.

Recent findings: In the last years, we have witnessed a renewed interest in CO2 kinetics in relation with a better understanding of volumetric capnography and its derived parameters. This together with technological advances and improved measurement systems have expanded the monitoring potential of CO2 kinetics including breath by breath continuous end-expiratory lung volume and continuous noninvasive cardiac output. Dead space has slowly been gaining relevance in clinical monitoring and prognostic evaluation. Easy to measure dead space surrogates such as the ventilatory ratio have demonstrated a strong prognostic value in patients with acute respiratory failure.

Summary: The kinetics of carbon dioxide describe many relevant physiological processes. The clinical introduction of new ways of assessing respiratory and circulatory efficiency based on advanced analysis of CO2 kinetics are paving the road to a long-desired goal in clinical monitoring of critically ill patients: the integration of respiratory and circulatory monitoring during mechanical ventilation.

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监测二氧化碳动力学作为心肺效率的标志。
综述的目的:描述二氧化碳动力学在临床呼吸和心血管监测中当前和近期的发展与应用:最近几年,随着人们对容积式气压图及其衍生参数有了更深入的了解,二氧化碳动力学再次引起了人们的关注。这与技术进步和测量系统的改进一起,扩大了二氧化碳动力学的监测潜力,包括逐次呼吸连续呼气末肺活量和连续无创心排血量。死腔在临床监测和预后评估中的相关性正在慢慢增加。易于测量的死腔代用指标,如通气比值,已在急性呼吸衰竭患者中显示出很强的预后价值。基于二氧化碳动力学的高级分析,在临床上引入了评估呼吸和循环效率的新方法,为实现危重病人临床监测的一个长期愿望目标铺平了道路:在机械通气过程中整合呼吸和循环监测。
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来源期刊
Current Opinion in Critical Care
Current Opinion in Critical Care 医学-危重病医学
CiteScore
5.90
自引率
3.00%
发文量
172
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​​Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.
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