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Venous hypercapnia during circulatory failure is attributed to reduction in oxygen delivery and impairment of tissue carbon dioxide clearance. Several studies in animal models showed that mixed venous - arterial carbon dioxide (MVA-CO2) tension gradient was increased when oxygen delivery to tissues (DO2) was experimentally diminished by positive end expiratory pressure, cardiac tamponade or bleeding. n the absence of a pulmonary artery catheters or an oesophageal Doppler, measurement of ΔCVA-CO2 gradient can be used to guide volume loading and to assess its effect on DO2.
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