Abstract:
OBJECTIVES:(1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO(2)). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. DESIGN:Prospective, interventional study. SETTING:Research laboratory at a university center. SUBJECTS:Fourteen anesthetized, mechanically ventilated dogs. INTERVENTIONS:Twenty milliliters per kilogram bleeding. MEASUREMENTS AND MAIN RESULTS:We placed pulmonary, aortic and mesenteric venous catheters, and an electromagnetic flow probe in the superior mesenteric artery, and gastric, jejunal and ileal tonometers to measure flows, arterial and venous blood gases and lactate, and intramucosal PCO(2). We calculated systemic and intestinal oxygen transport (DO(2)) and consumption (VO(2)), pHi and arterial minus intramucosal PCO(2) (DeltaPCO(2)). Then, we bled the dogs and repeated the measurements after 30 min. Systemic and intestinal DO(2) fell (26.0+/-7.3 versus 8.9+/-2.6 and 71.9+/-17.3 versus 24.6+/-9.6 ml/min per kg, respectively, p<0.0001). Systemic and intestinal VO(2) remained unchanged (5.5+/-1.3 versus 5.4+/-1.3 and 15.7+/-5.0 versus 14.9+/-5.3 ml/min per kg, respectively). Gastric, jejunal and ileal pHi (7.13+/-0.11 versus 6.96+/-0.17, 7.18+/-0.06 versus 6.97+/-0.15, 7.12+/-0.11 versus 6.94+/-0.14, p<0.05) and DeltaPCO(2) (21+/-13 versus 35+/-23, 15+/-5 versus 33+/-16, 23+/-17 versus 38+/-20, p<0.05) changed accordingly. Arterial and mesenteric venous lactate and their difference, rose significantly (1.7+/-0.9 versus 3.7+/-1.4 and 1.8+/-0.8 versus 4.3+/-1.5 mmol/l, 0.1+/-0.6 versus 0.6+/-0.7 mmol/l, p<0.05). CONCLUSIONS:During hemorrhage, systemic and intestinal VO(2) remained stable. However, hyperlactatemia and intramucosal acidosis evidenced anaerobic metabolism. pHi changes paralleled in the three intestinal segments.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Dubin A,Estenssoro E,Murias G,Canales H,Sottile P,Badie J,Barán M,Pálizas F,Laporte M,Rivas Díaz Mdoi
10.1007/s00134-001-1138-9keywords:
subject
Has Abstractpub_date
2001-12-01 00:00:00pages
1931-6issue
12eissn
0342-4642issn
1432-1238journal_volume
27pub_type
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254517
更新日期:1986-01-01 00:00:00
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更新日期:1996-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1980-08-01 00:00:00
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更新日期:2001-07-01 00:00:00
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更新日期:2010-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2019-05-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1007/s001340050595
更新日期:1998-05-01 00:00:00
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更新日期:2003-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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更新日期:2012-10-01 00:00:00
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更新日期:2003-02-01 00:00:00
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更新日期:2008-01-01 00:00:00
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更新日期:2014-09-01 00:00:00