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Titolo:
Application of fiberoptic sensors for the study of hepatic dysoxia in swine hemorrhagic shock
Autore:
Soller, BR; Heard, SO; Cingo, NA; Hsi, C; Favreau, J; Khan, T; Ross, RR; Puyana, JC;
Indirizzi:
Univ Massachusetts, Sch Med, Dept Surg, Worcester, MA 01655 USA Univ Massachusetts Worcester MA USA 01655 t Surg, Worcester, MA 01655 USA Univ Massachusetts, Sch Med, Dept Anesthesiol, Worcester, MA 01655 USA Univ Massachusetts Worcester MA USA 01655 hesiol, Worcester, MA 01655 USA Coll Holy Cross, Dept Phys, Worcester, MA 01610 USA Coll Holy Cross Worcester MA USA 01610 Dept Phys, Worcester, MA 01610 USA Brigham & Womens Hosp, Dept Surg, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 Dept Surg, Boston, MA 02115 USA
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 7, volume: 29, anno: 2001,
pagine: 1438 - 1444
SICI:
0090-3493(200107)29:7<1438:AOFSFT>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
PH; PCO2; RESUSCITATION; INDICATOR; ACIDOSIS; DELIVERY; PO-2; CO2;
Keywords:
dysoxia; liver; anaerobic metabolism; pH; Po-2; Pco(2); fiberoptic sensor; physiologic monitoring; hemorrhagic shock; swine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Soller, BR Univ Massachusetts, Sch Med, Dept Surg, 55 Lake Ave N, Worcester, MA 01655USA Univ Massachusetts 55 Lake Ave N Worcester MA USA 01655 1655USA
Citazione:
B.R. Soller et al., "Application of fiberoptic sensors for the study of hepatic dysoxia in swine hemorrhagic shock", CRIT CARE M, 29(7), 2001, pp. 1438-1444

Abstract

Objectives: To determine whether the simultaneous measurement of tissue pH, Pco(2), and Po-2 with a multiple-parameter fiberoptic sensor can be used to indicate the onset of hepatic dysoxia, to determine critical values, andto assess their use in predicting negative outcomes. Design: Prospective animal study. Setting: University research laboratory. Subjects: Fourteen Yorkshire swine. Interventions: Hemorrhagic shock (n = 11) was induced over 15 mins to lower systolic blood pressure to 40 mm Hg and was maintained for 30, 60, or 90 mins. Resuscitation was achieved with shed blood and warm saline to maintain mean pressure > 60 mm Hg for 120 mins. Sham animals (n = 3) were subjected to 90 mins of sham shock, followed by a 120-min recovery period,Measurements and Main Results: The multiple-parameter sensor continuously measured tissue pH, Pco(2), and Po-2 pH and Pco(2), indicators of anaerobicmetabolism, were plotted against tissue Po-2. All shocked animals, but no sham animals, showed a biphasic relationship between Po-2 and both pH and Pco(2). Curves were fit to both an exponential and a dual-line linear function to determine critical values for Po-2, pH, and Pco(2). The length of time the animal was dysoxic was evaluated as a predictor of negative outcome. Critical values determined from the exponential models were more sensitive indicators of negative outcome than values determined from the linear modeland more sensitive than arterial lactate and tonometric intramucosal pH and Pco(2),Conclusions: The multiple-parameter sensor offers the unique opportunity to study solid as well as hollow organ dysoxia through the simultaneous measurement of interstitial pH, Pco(2), and Po-2 in a small tissue region. The gradual transition from sufficient oxygen availability to dysoxia as a result of hemorrhage was better described by an exponential equation. The length of time that ph was below or Pco(2) was above the critical value determined from the exponential model was predictive of a negative outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 17:47:13