Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia.
Acta Anaesthesiol Scand
; 56(2): 200-9, 2012 Feb.
Article
en En
| MEDLINE
| ID: mdl-22103593
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate how tissue gas tensions and tissue metabolites measured in situ can detect hypoperfusion and differentiate between aerobic and anaerobic conditions during hemorrhagic shock. We hypothesized that tissue PCO(2) (PtCO(2)) would detect hypoperfusion also under aerobic conditions and detect anaerobic metabolism concomitantly with or earlier than other markers.METHODS:
Prospective experimental animal study with eight anesthetized pigs subjected to a continuous blood loss â¼8% of total blood volume per hour until death. We measured cardiac index, organ blood flows, and tissue levels of PO(2), PCO(2), glucose, pyruvate, lactate, and glycerol in intestine, liver, kidney, and skeletal muscle.RESULTS:
With reduction in blood flow to the organs under aerobic conditions, PtCO(2) increased â¼1-4 kPa from baseline. With the onset of tissue hypoxia there was a pronounced increase of PtCO(2), lactate, lactate-pyruvate (LP) ratio, and glycerol. Tissue pH and bicarbonate decreased significantly, indicating that metabolic acid was buffered by bicarbonate to generate CO(2).CONCLUSION:
Moderate tissue hypoperfusion under aerobic conditions is associated with increased PtCO(2), in contrast to metabolic parameters of ischemia (lactate, LP ratio, and glycerol) which remain low. From the onset of ischemia there is a much more rapid and pronounced increase in PtCO(2), lactate, and LP ratio. PtCO(2) can be used as a marker of hypoperfusion under both aerobic and anaerobic conditions; it gives an earlier warning of hypoperfusion than metabolic markers and increases concomitantly with or earlier than other markers at the onset of tissue anaerobiosis.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Flujo Sanguíneo Regional
/
Gases
/
Isquemia
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Límite:
Animals
Idioma:
En
Revista:
Acta Anaesthesiol Scand
Año:
2012
Tipo del documento:
Article
País de afiliación:
Noruega