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Monitoring Microcirculatory Blood Flow with a New Sublingual Tonometer in a Porcine Model of Hemorrhagic Shock

Tissue capnometry may be suitable for the indirect evaluation of regional hypoperfusion. We tested the performance of a new sublingual capillary tonometer in experimental hemorrhage. Thirty-six anesthetized, ventilated mini pigs were divided into sham-operated (n = 9) and shock groups (n = 27). Hemo...

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Detalles Bibliográficos
Autores principales: Palágyi, Péter, Kaszaki, József, Rostás, Andrea, Érces, Dániel, Németh, Márton, Boros, Mihály, Molnár, Zsolt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609384/
https://www.ncbi.nlm.nih.gov/pubmed/26504837
http://dx.doi.org/10.1155/2015/847152
Descripción
Sumario:Tissue capnometry may be suitable for the indirect evaluation of regional hypoperfusion. We tested the performance of a new sublingual capillary tonometer in experimental hemorrhage. Thirty-six anesthetized, ventilated mini pigs were divided into sham-operated (n = 9) and shock groups (n = 27). Hemorrhagic shock was induced by reducing mean arterial pressure (MAP) to 40 mmHg for 60 min, after which fluid resuscitation started aiming to increase MAP to 75% of the baseline value (60–180 min). Sublingual carbon-dioxide partial pressure was measured by tonometry, using a specially coiled silicone rubber tube. Mucosal red blood cell velocity (RBCV) and capillary perfusion rate (CPR) were assessed by orthogonal polarization spectral (OPS) imaging. In the 60 min shock phase a significant drop in cardiac index was accompanied by reduction in sublingual RBCV and CPR and significant increase in the sublingual mucosal-to-arterial PCO(2) gap (P(SL)CO(2) gap), which significantly improved during the 120 min resuscitation phase. There was significant correlation between P(SL)CO(2) gap and sublingual RBCV (r = −0.65, p < 0.0001), CPR (r = −0.64, p < 0.0001), central venous oxygen saturation (r = −0.50, p < 0.0001), and central venous-to-arterial PCO(2) difference (r = 0.62, p < 0.0001). This new sublingual tonometer may be an appropriate tool for the indirect evaluation of circulatory changes in shock.