Hypercapnic acidosis preserves gastric mucosal microvascular oxygen saturation in a canine model of hemorrhage
| Autor: | Lothar A. Schwarte, Olaf Picker, Ingo Schwartges, Thomas Scheeren, Christopher Beck |
|---|---|
| Přispěvatelé: | Anesthesiology, ICaR - Ischemia and repair |
| Rok vydání: | 2010 |
| Předmět: |
Male
Cardiac output CARRYING CAPACITY Lung injury Shock Hemorrhagic Critical Care and Intensive Care Medicine Sevoflurane gastrointestinal microcirculation Hypercapnia hemorrhagic shock CARBON-DIOXIDE Random Allocation ORGAN DYSFUNCTION Dogs medicine tissue oxygenation Animals CARDIAC-OUTPUT Respiratory acidosis Acidosis VENTILATED DOGS BLOOD-FLOW business.industry Microcirculation Oxygenation medicine.disease SYSTEMIC SEPSIS Oxygen Gastric Mucosa Anesthesia Emergency Medicine TRAUMATIC SHOCK RESUSCITATION Female Acidosis Respiratory medicine.symptom EPIDURAL-ANESTHESIA business Splanchnic LUNG INJURY medicine.drug splanchnic mucosa |
| Zdroj: | Shock, 34(6), 636-642. LIPPINCOTT WILLIAMS & WILKINS Schwartges, I, Picker, O, Beck, C, Scheeren, T W L & Schwarte, L A 2010, ' Hypercapnic Acidosis Preserves Gastric Mucosal Microvascular Oxygen Saturation in A Canine Model of Hemorrhage ', Shock, vol. 34, no. 6, pp. 636-642 . https://doi.org/10.1097/SHK.0b013e3181e68422 Shock, 34(6), 636-642. Lippincott Williams and Wilkins |
| ISSN: | 1540-0514 1073-2322 |
| Popis: | The authors aimed to clarify the effects of hypercapnic acidosis and its timing on gastric mucosal oxygenation in a canine model of hemorrhage. This was designed as a prospective, controlled, randomized animal study set in a university research laboratory. Five chronically instrumented dogs were used. Dogs were repeatedly anesthetized (sevoflurane 1.5 MAC), mechanically ventilated, and randomized to each of the following protocols. In a control series (CON), animals underwent hemorrhage during normoventilation (etCO(2), 35 mmHg). In a second series, hypercapnia (etCO(2), 70 mmHg) was applied before onset of hemorrhage (prophylactic hypercapnia), whereas in the third series, hypercapnia was applied after hemorrhage (therapeutic hypercapnia, THE). Microvascular oxygenation (mu HbO(2)) of the gastric mucosa was continuously assessed by tissue reflectance spectrophotometry. Cardiac output was continuously measured, and oxygen delivery (DO2) was intermittently calculated. In CON, hemorrhage decreased DO2 (from 11 +/- 3 mL.kg(-1).min(-1) to 8 +/- 2 mL.kg(-1).min(-1) and 8 +/- 2 mL.kg(-1).min(-1) after 30 and 75 min, respectively) and mu HbO(2) (from 57% +/- 4% to 43% +/- 11% and 50% +/- 11%). Prophylactic hypercapnia attenuated the effects of hemorrhage on DO2 (12 +/- 2 mL.kg(-1).min(-1) to 10 +/- 2 mL.kg(-1).min(-1) and 11 +/- 2 mL.kg(-1).min(-1)) and preserved mu HbO(2) (52% +/- 3% to 47% +/- 5% and 57% T 3%). Initial effects of hemorrhage in THE were comparable to CON (DO2 from 11 +/- 2 mL.kg(-1).min(-1) to 8 +/- 1 mL.kg(-1).min(-1); mu HbO(2) from 56% +/- 7% to 43% +/- 9%), but after application of hypercapnic acidosis, baseline levels were restored (DO2 10 +/- 3 mL.kg(-1).min(-1); mu HbO(2) 52% +/- 14%). Hypercapnic acidosis applied before or after hemorrhage (THE) preserves microvascular mucosal oxygenation. If these experimental findings may be transferred to the clinical setting, deliberate hypercapnic acidosis could serve to augment oxygenation of the splanchnic region in states of compromised circulation, e. g., hemorrhage. |
| Databáze: | OpenAIRE |
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