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

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 (PSLCO2 gap), which significantly improved during the 120 min resuscitation phase. There was significant correlation between PSLCO2 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.

• Authors: Péter Palágyi, József Kaszaki, Andrea Rostás, Dániel Érces, Márton Németh, Mihály Boros, Zsolt Molnár
• Journal: BioMed research international (Biomed Res Int) Vol. 2015 Pg. 847152 ( 2015) ISSN: 2314-6141 [Electronic] United States
• PMID: 26504837 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Animals
• Disease Models, Animal
• Equipment Design
• Manometry (instrumentation, methods)
• Microcirculation (physiology)
• Monitoring, Physiologic (instrumentation, methods)
• Mouth Floor (blood supply, physiology)
• Shock, Hemorrhagic (physiopathology)
• Swine