Determination of Mixed Venous CO₂ Tensions by Rebreathing

¹ From the Department of Medicine, College of Medical Evangelists, Los Angeles, and the Rancho los Amigos Respiratory Center for Poliomyelitis, Hondo, California

A rapid infrared CO₂ analyzer has been used to evaluate a bag rebreathing method for the determination of mixed venous CO₂ tension. Using small bag volumes and an initial bag CO₂ tension averaging 11 mm Hg above effective alveolar tension, a plateau of CO₂ concentration was obtained during normal spontaneous breathing in 18 seconds or less in 16 out of 18 trials during cardiac catheterization. The plateau so obtained was compared with the CO₂ tension of a mixed venous sample drawn approximately 1 minute before the rebreathing procedure. The mean difference between the two was +0.1 mm Hg with a standard deviation of 3.1 mm Hg. This accuracy is not sufficient for the determination of cardiac output. Recirculation of blood within the rebreathing period did not introduce apparent errors. The mixed venous CO₂ tension by the rebreathing method was determined with greater accuracy than was the effective alveolar CO₂ tension from the peak end-tidal CO₂ tensions. Abnormalities of distribution of the blood and gas in the lung interfered less with the determination of mixed venous tension by this method than with the determination of alveolar CO₂ tension. Thus it is possible to utilize the mixed venous CO₂ tension as obtained from rebreathing plateaus to evaluate the ventilatory status of subjects with moderate abnormalities of distribution of gas and blood in the lungs.

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