Comparisons Between Sublingual and Gastric Tonometry During Hemorrhagic Shock

Póvoas, Heitor P.; Weil, Max Harry; Tang, Wanchun; Moran, Buzz; Kamohara, Takashi; Bisera, Joe

doi:10.1378/chest.118.4.1127

Cited by 96 publications

(40 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These authors have demonstrated an increase in sublingual PCO 2 (PslCO 2 ) that was closely related to decreases in arterial pressure and cardiac index during circulatory shock produced by hemorrhage and sepsis . [35,[88][89][90]. Furthermore, the increase in PslCO 2 closely tracked the increase in PimCO 2 .…”

Section: Sublingual Capnometrymentioning

confidence: 63%

Regional carbon dioxide monitoring to assess the adequacy of tissue perfusion

Marik¹

2005

Current Opinion in Critical Care

View full text Add to dashboard Cite

show abstract

Section: Sublingual Capnometrymentioning

confidence: 63%

Regional carbon dioxide monitoring to assess the adequacy of tissue perfusion

Marik¹

2005

Current Opinion in Critical Care

View full text Add to dashboard Cite

show abstract

“…In animals, ileum has been used to assess splanchnic perfusion [25,36] – a clinically impractical procedure. Studies have demonstrated that sublingual capnometry, a relatively noninvasive procedure, correlates with gastric tonometry [26,40,41,42]. Practically, it may be difficult to lodge the sensor securely under the tongue in uncooperative patients, thereby preventing equilibration with tissue P CO 2 [27].…”

Section: Discussionmentioning

confidence: 99%

Esophageal capnometry during hemorrhagic shock and after resuscitation in rats

et al. 2002

View full text Add to dashboard Cite

Correspondence: Dan Torbati, Dan.Torbati@MCH.Com 79 HR = heart rate; MABP = mean arterial blood pressure; PaCO 2 = arterial partial carbon dioxide tension; PCO 2 = partial carbon dioxide tension; PeCO 2 = esophageal partial carbon dioxide tension. AbstractBackground 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 steadystate 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.

show abstract

“…[34], interest turned to the capnometric monitoring at other sites of the gastrointestinal mucosa. In the last decades, several investigators have reported a correlation between the PCO 2 values of the oral and gastric mucosa in different pathological conditions [35,36] and has resulted in the use of sublingual or buccal mucosal capnometry. These methods do not have the limitations of gastric tonometry and are increasingly used for the measurement of PCO 2 in the mucosa, and the calculation of mucosal-to-arterial PCO 2 gap [3,37].…”

Section: The Correlation Between Gastric Mucosal Perfusion and Emptyimentioning

confidence: 99%

Recent Advances Of Mucosal Capnometry And The Perspectives Of Gastrointestinal Monitoring In The Critically Ill. A Pilot Study

Palágyi

Barna

Csábi

et al. 2016

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

Mucosal capnometry involves the monitoring of partial pressure of carbon dioxide (PCO2) in mucous membranes. Different techniques have been developed and applied for this purpose, including sublingual or buccal sensors, or special gastrointestinal tonometric devices. The primary use of these procedures is to detect compensated shock in critically ill patients or patients undergoing major surgery. Compensatory mechanisms, in the early phases of shock, lead to the redistribution of blood flow towards the vital organs, within ostensibly typical macro-haemodynamic parameters. Unfortunately, this may result in microcirculatory disturbances, which can play a pivotal role in the development of organ failure. In such circumstances mucosal capnometry monitoring, at different gastrointestinal sites, can provide a sensitive method for the early diagnosis of shock. The special PCO2 monitoring methods assess the severity of ischaemia and help to define the necessary therapeutic interventions and testing of these monitors have justified their prognostic value. Gastrointestinal mucosal capnometry monitoring also helps in determining the severity of ischaemia and is a useful adjunctive in the diagnosis of occlusive splanchnic arterial diseases. The supplementary functional information increases the diagnostic accuracy of radiological techniques, assists in creating individualized treatment plans, and helps in follow-up the results of interventions. The results of a pilot study focusing on the interrelation of splanchnic perfusion and gastrointestinal function are given and discussed concerning recent advances in mucosal capnometry.

show abstract

Comparisons Between Sublingual and Gastric Tonometry During Hemorrhagic Shock

Cited by 96 publications

References 20 publications

Regional carbon dioxide monitoring to assess the adequacy of tissue perfusion

Regional carbon dioxide monitoring to assess the adequacy of tissue perfusion

Esophageal capnometry during hemorrhagic shock and after resuscitation in rats

Recent Advances Of Mucosal Capnometry And The Perspectives Of Gastrointestinal Monitoring In The Critically Ill. A Pilot Study

Contact Info

Product

Resources

About