Background Venous–arterial carbon dioxide (CO 2 ) to arterial–venous oxygen (O 2 ) content difference ratio (Cv-aCO 2 /Ca-vO 2 ) > 1 is supposed to be both sensitive and specific for anaerobic metabolism. What regional hemodynamic and metabolic parameters determine the ratio has not been clarified. Objectives To address determinants of systemic and renal, spleen, gut and liver Cv-aCO 2 /Ca-vO 2 . Methods Post hoc analysis of original data from published experimental studies aimed to address effects of different fluid resuscitation strategies on oxygen transport, lactate metabolism and organ dysfunction in fecal peritonitis and endotoxin infusion, and from animals in cardiac tamponade or hypoxic hypoxia. Systemic and regional hemodynamics, blood flow, lactate uptake, carbon dioxide and oxygen-derived variables were determined. Generalized estimating equations (GEE) were fit to assess contributors to systemic and regional Cv-aCO 2 /Ca-vO 2 . Results Median (range) of pooled systemic Cv-aCO 2 /Ca-vO 2 in 64 pigs was 1.02 (0.02 to 3.84). While parameters reflecting regional lactate exchange were variably associated with the respective regional Cv-aCO 2 /Ca-vO 2 ratios, only regional ratios were independently correlated with systemic ratio: renal Cv-aCO 2 /Ca-vO 2 ( β = 0.148, 95% CI 0.062 to 0.234; p = 0.001), spleen Cv-aCO 2 /Ca-vO 2 ( β = 0.065, 95% CI 0.002 to 0.127; p = 0.042), gut Cv-aCO 2 /Ca-vO 2 ( β = 0.117, 95% CI 0.025 to 0.209; p = 0.013), liver Cv-aCO 2 /Ca-vO 2 ( β = − 0.159, 95% CI − 0.297 to − 0.022; p = 0.023), hepatosplanchnic Cv-aCO 2 /Ca-vO 2 ( β = 0.495, 95% CI 0.205 to 0.786; p = 0.001). Conclusion In a mixed set of animals in different shock forms or during hypoxic injury, hepatosplanchnic Cv-aCO 2 /Ca-vO 2 ratio had the strongest independent association with systemic Cv-aCO 2 /Ca-vO 2 , while no independent association was demonstrated for lactate or hemodynamic variables.

中文翻译：

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实验性循环休克和缺氧时区域静脉-动脉 CO2 与动静脉 O2 含量差异比

背景 静脉-动脉二氧化碳 (CO 2 ) 与动脉-静脉氧 (O 2 ) 含量差异比 (Cv-aCO 2 /Ca-vO 2 ) > 1 被认为对厌氧代谢既敏感又特异。哪些区域血流动力学和代谢参数决定了该比率尚未阐明。目的 解决全身和肾脏、脾脏、肠道和肝脏 Cv-aCO 2 /Ca-vO 2 的决定因素。方法 对来自已发表实验研究的原始数据进行事后分析，旨在解决不同液体复苏策略对粪便腹膜炎和内毒素输注中的氧气运输、乳酸代谢和器官功能障碍的影响，以及来自心脏压塞或缺氧缺氧的动物​​。确定了全身和区域血流动力学、血流量、乳酸摄取、二氧化碳和氧衍生变量。广义估计方程 (GEE) 适合评估系统和区域 Cv-aCO 2 /Ca-vO 2 的贡献者。结果 64 头猪的混合全身 Cv-aCO 2 /Ca-vO 2 的中位数（范围）为 1.02（0.02 至 3.84）。虽然反映区域乳酸交换的参数与各自区域的 Cv-aCO 2 /Ca-vO 2 比率不同，但只有区域比率与全身比率独立相关：肾 Cv-aCO 2 /Ca-vO 2 (β = 0.148, 95 % CI 0.062 至 0.234；p = 0.001)，脾脏 Cv-aCO 2 /Ca-vO 2 (β = 0.065，95% CI 0.002 至 0.127；p = 0.042)，肠道 Cv-aCO 2 /Ca-vO 2 = 0.117，95% CI 0.025 至 0.209；p = 0.013)，肝脏 Cv-aCO 2 /Ca-vO 2 (β = − 0.159，95% CI − 0.297 至 − 0.022；p = 0.023)，Cv-aCO 2 /Ca-vO 2 /Ca-vO 2 (β = 0.495，95% CI 0.205 至 0.786；p = 0.001)。