GASTRIC-ARTERIAL PCO2 GRADIENT DOES NOT REFLECT SYSTEMIC AND SPLANCHNIC HEMODYNAMICS OR OXYGEN TRANSPORT AFTER CARDIAC SURGERY

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Abstract
Gastric mucosal-arterial PCO2 gradient (Pg-aCO2) is used to assess splanchnic perfusion and oxygenation. We evaluated whether Pg-aCO2 reflects whole body (Q) and splanchnic (Qsp) blood flow, oxygen delivery (DO2) and consumption (VO2) after coronary artery by pass graft (CABG) operation. Thirty patients received dobutamine or dopexamine to increase cardiac index, 15 patients enalapril or sodium nitroprusside to lower blood pressure, and 30 patients were controls. We measured Q, Qsp (hepatic vein catheter and indocyanine green), and gastric mucosal PCO2 (nasogastric tonometer) before and after interventions. Multiple linear regression model showed that none of the changes in Q, Qsp, and splanchnic or systemic DO2 and VO2 significantly explained changes in Pg-aCO2 (ΔPg-aCO2). All independent variables together explained only 7% of ΔPg-aCO2. Increased splanchnic blood flow (0.65 ± .19 vs. 0.94 ± .31 L/min/m2, P 2

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