Effects of hemorrhage on gastrointestinal oxygenation

Objectives: (1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO2). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. Design: Prospective, interventional study. Setting: Research laboratory at a...

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Autores principales: Dubin, Arnaldo, Estenssoro, Elisa, Murias, Gastón, Canales, Héctor Saúl, Sottile, Juan Pablo, Badie, Julio Ezequiel, Barán, Marcelo, Palizas, Fernando, Laporte, Mercedes, Rivas Díaz, Mariana
Formato: Articulo
Lenguaje:Inglés
Publicado: 2001
Materias:
Ciencias Médicas
Intramucosal pH
Tonometry
Shock
Oxygen consumption
Oxygen delivery
Lactate
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/142032
Aporte de:
SEDICI (UNLP) de Universidad Nacional de La Plata
id I19-R120-10915-142032
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Médicas
Intramucosal pH
Tonometry
Shock
Oxygen consumption
Oxygen delivery
Lactate
spellingShingle Ciencias Médicas
Intramucosal pH
Tonometry
Shock
Oxygen consumption
Oxygen delivery
Lactate
Dubin, Arnaldo
Estenssoro, Elisa
Murias, Gastón
Canales, Héctor Saúl
Sottile, Juan Pablo
Badie, Julio Ezequiel
Barán, Marcelo
Palizas, Fernando
Laporte, Mercedes
Rivas Díaz, Mariana
Effects of hemorrhage on gastrointestinal oxygenation
topic_facet Ciencias Médicas
Intramucosal pH
Tonometry
Shock
Oxygen consumption
Oxygen delivery
Lactate
description Objectives: (1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO2). (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 PCO2. We calculated systemic and intestinal oxygen transport (DO2) and consumption (VO2), pHi and arterial minus intramucosal PCO2 (ΔPCO2). Then, we bled the dogs and repeated the measurements after 30 min. Systemic and intestinal DO2 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 VO2 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 ΔPCO2 (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 VO2 remained stable. However, hyperlactatemia and intramucosal acidosis evidenced anaerobic metabolism. pHi changes paralleled in the three intestinal segments.
format Articulo
Articulo
author Dubin, Arnaldo
Estenssoro, Elisa
Murias, Gastón
Canales, Héctor Saúl
Sottile, Juan Pablo
Badie, Julio Ezequiel
Barán, Marcelo
Palizas, Fernando
Laporte, Mercedes
Rivas Díaz, Mariana
author_facet Dubin, Arnaldo
Estenssoro, Elisa
Murias, Gastón
Canales, Héctor Saúl
Sottile, Juan Pablo
Badie, Julio Ezequiel
Barán, Marcelo
Palizas, Fernando
Laporte, Mercedes
Rivas Díaz, Mariana
author_sort Dubin, Arnaldo
title Effects of hemorrhage on gastrointestinal oxygenation
title_short Effects of hemorrhage on gastrointestinal oxygenation
title_full Effects of hemorrhage on gastrointestinal oxygenation
title_fullStr Effects of hemorrhage on gastrointestinal oxygenation
title_full_unstemmed Effects of hemorrhage on gastrointestinal oxygenation
title_sort effects of hemorrhage on gastrointestinal oxygenation
publishDate 2001
url http://sedici.unlp.edu.ar/handle/10915/142032
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