2012 OPEN FORUM Abstracts
MEASUREMENT OF BLOOD GAS CHANGES AND ARTERIOVENOUS OXYGEN CONTENT DIFFERENCE FOLLOWING INJECTION OF COLD SUPERSATURATED DISSOLVED OXYGEN SOLUTION IN VITRO.
Daniel J. Grady1, Michael A. Gentile2, John H. Riggs3, Terrence F. Smith1, Todd McCarl1, Ira M. Cheifetz2, Gregg Stashenko1; 1Respiratory Care, Mission Health System, Asheville, NC; 2Pediatric Critical Care Medicine, Duke University Health System, Durham, NC; 3Clinical Research, VentLab, Inc, Mocksville, NC
Background: Mixing supersaturated dissolved oxygen solution, (which contains dissolved partial pressures of oxygen greater than 900 mm. Hg) with arterial blood, will increase blood oxygenation in vivo 1. The objective of this study was to evaluate blood gas changes and the arteriovenous oxygen content differences following injection of equal volumes of cold supersaturated dissolved oxygen solution into arterial and venous blood samples in a swine model. Methods: The supersaturated dissolved oxygen solution was prepared by bubbling gaseous oxygen at 3 L/min through 1.0 liter of Lactated Ringers solution, at a temperature of 49 degrees F = 9.4 C for 20 min using a novel hyperbaric tonometer. The dissolved O2 of the supersaturated solution was 42 mg/L, as measured by a Hanna Instruments HI 98186 Dissolved Oxygen analyzer; which converts to 1050 mm Hg. The supersaturated dissolved oxygen solution (2.5 ml) was mixed with 2.5 ml. arterial and venous blood samples; and both of the mixed samples were re-analyzed using an IL Gem Premier analyzer. An arterial and venous blood sample were obtained from a single swine following line placement and stabilization on mechanical ventilation. Results: The injection of 2.5 ml of cold (49 F = 9.4 C) supersaturated solution into 2.5 ml arterial and venous blood samples produced the following results: Changes in arterial blood: 1. PaCO2 decreased by 29 mm. Hg. = 59%. 2. PaO2 increased by 437 mm. Hg. = 455% 3. SaO2 increased by 2.0%. 4. CaO2 increased by 1.58 vol%= 18%. Changes in venous blood: 1. PvCO2 decreased by 33 mm Hg = 60% 2. PvO2 increased by 185 mm Hg = 462%. 3. SvO2 increased by 26% = 35% 4. CvO2 increased by 2.7 vol% = 43%. Changes In the C(a-v)O2 difference; 1. There was a decrease of 1.41 vol% in the C(a-v)O2 difference, which equals a decrease of 44%, when C(a-v)O2 baseline is compared to C(a-v)O2 difference following injection of supersaturated dissolved oxygen solution. Conclusions: When arterial and venous blood samples are mixed with equal volumes of supersaturated dissolved oxygen solution, substantial increases occur in PaO2, SaO2, and Oxygen Content in both arterial and venous blood samples. Further, the arterio-venous oxygen content difference decreased by approximately 44%. Additional research is necessary to determine blood gas changes following (1) a bolus injection and (2) continuous IV infusion of supersaturated dissolved oxygen solution. Sponsored Research - The study was supported by a partial grant from Outcome Solutions, LLC. Arterial and Venous Blood Gas Changes In Vitro Following Injection of 2.5 ml Cold Supersaturated Dissolved Oxygen Solution 1. Stone et al. Effect of Supersaturated Oxygen Delivery on Infarct Size After Percutaneous Coronary Intervention in Acute Myocardial Infarction. Circulation, American Heart Association, October 2009, pp 366-374.