Monitoring Microcirculatory Blood Flow with a New Sublingual Tonometer in a Porcine Model of Hemorrhagic Shock. (4th October 2015)

• Record Type: Journal Article
• Authors: Palágyi, Péter; Kaszaki, József; Rostás, Andrea; Érces, Dániel; Németh, Márton; Boros, Mihály; Molnár, Zsolt
• Other Names: Cohn Stephen M. Academic Editor.
• Is Part Of: BioMed research international. Volume 2015(2015)
• Publication Date: 2015-10-04
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2015/847152
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : 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 PCO2 gap (P SL C O 2 gap), which significantly improved during the 120 min resuscitation phase. There was significant correlation between P SL C O 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 PCO2 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.