J Clin Monit Comput - How do changes in exhaled CO2 measure changes in cardiac output? A numerical analysis model.

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Resumo

JECTIVE: In a previous study in anesthetized animals, the slope of percent decreases in exhaled CO2 versus percent decreases in cardiac output (Q(T) inflation of vena cava balloons) was 0.73. To examine the mechanisms underlying this exhaled CO2-Q(T) relationship, an iterative numerical analysis computer model of non-steady state CO(2) kinetics was developed.METHODS: The model consisted of a large peripheral tissue compartment connected by venous return and [Formula: see text] to a small central pulmonary compartment. Equations were developed to describe the movement of CO2 in this system. Decreases in Q(T) were accompanied by experimentally measured increases in alveolar dead space fraction (VD: (alv)/VT: (alv)), generated by decreased pulmonary vascular pressure during the Q(T) decrease.RESULTS: When the model was perturbed by a 40% decrease in Q(T) and an increase in VD: (alv)/VT: (alv) from 5 to 20.6%, average alveolar expired P(CO2) (PAE(CO2)) decreased from 37.5 to 29.4 mm Hg, similar to the animal experiments. Due to the high peripheral tissue compliance for CO2, the computer model demonstrated that, after a decrease in Q(T), at least 1 h was required for compartment CO2 stores to approach a new equilibrium state.CONCLUSIONS: The numerical analysis computer model helps to delineate the mechanisms underlying how decreased Q(T) resulted in decreased exhaled CO2. The model permitted deconvolution of the effects of simultaneous variables and the interrogation of parameters that would be difficult to measure in actual experiments.

Resumo Limpo

jectiv previous studi anesthet anim slope percent decreas exhal co versus percent decreas cardiac output qt inflat vena cava balloon examin mechan under exhal coqt relationship iter numer analysi comput model nonsteadi state co kinet developedmethod model consist larg peripher tissu compart connect venous return formula see text small central pulmonari compart equat develop describ movement co system decreas qt accompani experiment measur increas alveolar dead space fraction vd alvvt alv generat decreas pulmonari vascular pressur qt decreaseresult model perturb decreas qt increas vd alvvt alv averag alveolar expir pco paeco decreas mm hg similar anim experi due high peripher tissu complianc co comput model demonstr decreas qt least h requir compart co store approach new equilibrium stateconclus numer analysi comput model help delin mechan under decreas qt result decreas exhal co model permit deconvolut effect simultan variabl interrog paramet difficult measur actual experi

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