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Esophageal capnometry during hemorrhagic shock and after resuscitation in rats

BACKGROUND: Splanchnic perfusion following hypovolemic shock is an important marker of adequate resuscitation. We tested whether the gap between esophageal partial carbon dioxide tension (PeCO(2)) and arterial partial carbon dioxide tension (PaCO(2)) is increased during graded hemorrhagic hypotensio...

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Autores principales: Totapally, Balagangadhar R, Fakioglu, Harun, Torbati, Dan, Wolfsdorf, Jack
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC154116/
https://www.ncbi.nlm.nih.gov/pubmed/12617744
http://dx.doi.org/10.1186/cc1856
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author Totapally, Balagangadhar R
Fakioglu, Harun
Torbati, Dan
Wolfsdorf, Jack
author_facet Totapally, Balagangadhar R
Fakioglu, Harun
Torbati, Dan
Wolfsdorf, Jack
author_sort Totapally, Balagangadhar R
collection PubMed
description BACKGROUND: Splanchnic perfusion following hypovolemic shock is an important marker of adequate resuscitation. We tested whether the gap between esophageal partial carbon dioxide tension (PeCO(2)) and arterial partial carbon dioxide tension (PaCO(2)) is increased during graded hemorrhagic hypotension and reversed after blood reinfusion, using a fiberoptic carbon dioxide sensor. MATERIALS AND METHOD: Ten Sprague–Dawley rats were anesthetized, tracheotomized, and cannulated in one femoral artery and vein. A calibrated fiberoptic PCO(2 )probe was inserted into the distal third of the esophagus for determination of luminal PeCO(2 )during maintained anesthesia (pentobarbital 15 mg/kg per hour), normothermia (38 ± 0.5°C), and fluid balance (saline 5 ml/kg per hour). Three out of 10 rats were used to determine the limits of hemodynamic stability during gradual hemorrhage. Seven of the 10 rats were then subjected to mild and severe hemorrhage (15 and 20–25 ml/kg, respectively). Thirty minutes after severe hemorrhage, these rats were resuscitated by reinfusion of the shed blood. Arterial gas exchange, hemodynamic variables, and PeCO(2 )were recorded at each steady-state level of hemorrhage (at 30 and 60 min) and after resuscitation. RESULTS: The PeCO(2)–PaCO(2 )gap was significantly increased after mild and severe hemorrhage and returned to baseline (prehemorrhagic) values following blood reinfusion. Base deficit increased significantly following severe hemorrhage and remained significantly elevated after blood reinfusion. Significant correlations were found between base deficit and PeCO(2)–PaCO(2 )(P < 0.002) and PeCO(2 )(P < 0.022). Blood bicarbonate concentration decreased significantly following mild and severe hemorrhage, but its recovery was not complete at 60 min after blood reinfusion. CONCLUSION: Esophageal–arterial PCO(2 )gap increases during graded hemorrhagic hypotension and returns to baseline value after resuscitation without complete reversal of the base deficit. These data suggest that esophageal capnometry could be used as an alternative for gastric tonometry during management of hypovolemic shock.
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spelling pubmed-1541162003-05-06 Esophageal capnometry during hemorrhagic shock and after resuscitation in rats Totapally, Balagangadhar R Fakioglu, Harun Torbati, Dan Wolfsdorf, Jack Crit Care Research BACKGROUND: Splanchnic perfusion following hypovolemic shock is an important marker of adequate resuscitation. We tested whether the gap between esophageal partial carbon dioxide tension (PeCO(2)) and arterial partial carbon dioxide tension (PaCO(2)) is increased during graded hemorrhagic hypotension and reversed after blood reinfusion, using a fiberoptic carbon dioxide sensor. MATERIALS AND METHOD: Ten Sprague–Dawley rats were anesthetized, tracheotomized, and cannulated in one femoral artery and vein. A calibrated fiberoptic PCO(2 )probe was inserted into the distal third of the esophagus for determination of luminal PeCO(2 )during maintained anesthesia (pentobarbital 15 mg/kg per hour), normothermia (38 ± 0.5°C), and fluid balance (saline 5 ml/kg per hour). Three out of 10 rats were used to determine the limits of hemodynamic stability during gradual hemorrhage. Seven of the 10 rats were then subjected to mild and severe hemorrhage (15 and 20–25 ml/kg, respectively). Thirty minutes after severe hemorrhage, these rats were resuscitated by reinfusion of the shed blood. Arterial gas exchange, hemodynamic variables, and PeCO(2 )were recorded at each steady-state level of hemorrhage (at 30 and 60 min) and after resuscitation. RESULTS: The PeCO(2)–PaCO(2 )gap was significantly increased after mild and severe hemorrhage and returned to baseline (prehemorrhagic) values following blood reinfusion. Base deficit increased significantly following severe hemorrhage and remained significantly elevated after blood reinfusion. Significant correlations were found between base deficit and PeCO(2)–PaCO(2 )(P < 0.002) and PeCO(2 )(P < 0.022). Blood bicarbonate concentration decreased significantly following mild and severe hemorrhage, but its recovery was not complete at 60 min after blood reinfusion. CONCLUSION: Esophageal–arterial PCO(2 )gap increases during graded hemorrhagic hypotension and returns to baseline value after resuscitation without complete reversal of the base deficit. These data suggest that esophageal capnometry could be used as an alternative for gastric tonometry during management of hypovolemic shock. BioMed Central 2003 2002-12-20 /pmc/articles/PMC154116/ /pubmed/12617744 http://dx.doi.org/10.1186/cc1856 Text en Copyright © 2003 Totapally et al., licensee BioMed Central Ltd
spellingShingle Research
Totapally, Balagangadhar R
Fakioglu, Harun
Torbati, Dan
Wolfsdorf, Jack
Esophageal capnometry during hemorrhagic shock and after resuscitation in rats
title Esophageal capnometry during hemorrhagic shock and after resuscitation in rats
title_full Esophageal capnometry during hemorrhagic shock and after resuscitation in rats
title_fullStr Esophageal capnometry during hemorrhagic shock and after resuscitation in rats
title_full_unstemmed Esophageal capnometry during hemorrhagic shock and after resuscitation in rats
title_short Esophageal capnometry during hemorrhagic shock and after resuscitation in rats
title_sort esophageal capnometry during hemorrhagic shock and after resuscitation in rats
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC154116/
https://www.ncbi.nlm.nih.gov/pubmed/12617744
http://dx.doi.org/10.1186/cc1856
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