Assessing gas exchange in acute lung injury/acute respiratory distress syndrome: Diagnostic techniques and prognostic relevance

Luciano Gattinoni, Eleonora Carlesso, Massimo Cressoni

Research output: Contribution to journalArticle

Abstract

Purpose of Review: To provide the most recent insights on the assessment of gas exchange in acute lung injury. Recent Findings: Central venous blood may be used as a surrogate of arterial blood to assess carbon dioxide tension and acid-base status. In contrast arterial oxygenation cannot be estimated with confidence from venous blood. However, the use of venous blood associated with pulse oximetry may provide the SvO2 which is useful for monitoring and targeting the resuscitation therapy. Impaired CO3 clearance and increased dead space have been confirmed as useful prognostic indices of structural lung damage and mortality in acute respiratory failure. A simplified technique based on multiple inert gas technique has been described to assess ventilation-perfusion mismatch while a new analysis of pulse oximetry has been suggested to detect lung opening and closing. Finally, new insight has been provided on the relationship between lung anatomy, as detected by computed tomography, oxygenation and CO3 clearance. Summary: Although oxygenation assessment is of primary importance during respiratory lung injury, dead space and CO3 retention are more strictly associated with outcome. The association of central venous blood analysis and pulse oximetry may provide more information than arterial blood alone.

Original languageEnglish
Pages (from-to)18-23
Number of pages6
JournalCurrent Opinion in Critical Care
Volume17
Issue number1
DOIs
Publication statusPublished - Feb 2011

Keywords

  • acute lung injury/acute respiratory distress syndrome
  • blood gas analysis
  • lung gas exchange
  • oxygen saturation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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