Detection of ischemia by Pco2 before adenosine triphosphate declines in skeletal muscle

Kvarstein, Gunnvald; Mirtaheri, Peyman; Tønnessen, Tor Inge

doi:10.1097/01.ccm.0000104948.41544.fc

Cited by 15 publications

(11 citation statements)

References 39 publications

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“…Tissue PCO 2 (PtCO 2 ) as a marker of hypoperfusion is supported by previous studies . Gastric tonometry has been shown to detect gastric hypoperfusion during shock .…”

mentioning

confidence: 70%

Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia

Wælgaard

Dahl

Kvarstein

et al. 2011

Acta Anaesthesiol Scand

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Moderate tissue hypoperfusion under aerobic conditions is associated with increased PtCO(2), in contrast to metabolic parameters of ischemia (lactate, LP ratio, and glycerol) which remain low. From the onset of ischemia there is a much more rapid and pronounced increase in PtCO(2), lactate, and LP ratio. PtCO(2) can be used as a marker of hypoperfusion under both aerobic and anaerobic conditions; it gives an earlier warning of hypoperfusion than metabolic markers and increases concomitantly with or earlier than other markers at the onset of tissue anaerobiosis.

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“…Tissue PCO 2 (PtCO 2 ) as a marker of hypoperfusion is supported by previous studies . Gastric tonometry has been shown to detect gastric hypoperfusion during shock .…”

mentioning

confidence: 70%

Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia

Wælgaard

Dahl

Kvarstein

et al. 2011

Acta Anaesthesiol Scand

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“…(Kvarstein et al 2004, Tronstad et al 2010 Furthermore, increase in tissue PCO 2 is related to increased mortality in hemorrhagic shock. (Sims et al 2001) Carbonic anhydrase in red blood cells plays the major role in the transport of tissue CO 2 to the lung for excretion.…”

Section: Discussionmentioning

confidence: 99%

“…One of the major functions of RBC is the transport of carbon dioxide (Geers and Gros 2000, Kvarstein et al 2004, Walter 2010. Large amount of CO 2 produced in the body depends on RBC to transport them to the lung.…”

Section: Introductionmentioning

confidence: 99%

Lowering of elevated tissue PCO₂in a hemorrhagic shock rat model after reinfusion of a novel nanobiotechnological polyhemoglobin-superoxide dismutase-catalase-carbonic anhydrase that is an oxygen and a carbon dioxide carrier with enhanced antioxidant properties

Bian

Gao

Chang

2013

Artificial Cells, Nanomedicine, and Biotechnology

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Even though erythrocytes transport both oxygen and carbon dioxide, research on blood substitutes has concentrated on the transport of oxygen and its vasoactivity and oxidative effects. Recent study in a hemorrhagic shock animal model shows that the degree of tissue PCO 2 elevation is directly related to mortality rates. We therefore prepared a novel nanobiotechnological carrier for both O 2 and CO 2 with enhanced antioxidant properties. This is based on the use of glutaraldehyde to crosslink stroma free hemoglobin (SFHb), superoxide dismutase (SOD), catalase (CAT) and carbonic anhydrase(CA)to form a soluble PolySFHb-SOD-CAT-CA. It was compared to blood and different resuscitation fluids on the ability to lower elevated tissue PCO 2 in a 2/3 blood volume loss rat hemorrhagic shock model. Sixty minutes of sustained hemorrhagic shock at 30 mm Hg resulted in the increase of tissue PCO 2 to 95 mm ± 3 mmHg from the control level of 55 mm Hg. Reinfusion of whole blood (Hb 15 g/dL with its RBC enzymes) lowered the tissue PCO2 to 72 ± 4.5 mmHg 60 minutes after reinfusion. PolySFHb-SOD-CAT-CA (SFHb 10 g/dL plus additional enzymes) was more effective than whole blood in lowering PCO 2 lowering this to 66.2 ±3.5 mmHg. Ringer's Lactated solution or polyhemoglobin lowered the elevated PCO2 only slightly to 87 ± 4.5 mmHg and 84.8 ± 1.5 mmHg, respectively. Moreover, ST-elevation for whole blood (Hb 15 g/dL) and PolySFHb-SOD-CAT-CA (Hb 10 g/dL) was respectively 12.8% ± 4% and 13.0% ± 2% of the control 60 minutes after reinfusion. Both are significantly better than those in the Ringer's lactated group and the PolyHb group. In conclusion, this novel approach for blood substitute design has resulted in a novel nanobiotechnological carrier for both O 2 and CO 2 with enhanced antioxidant properties.

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“…Local tissue partial pressures of CO 2 (PCO 2 ) increase when local cellular adenosine triphosphate use exceeds its rate of oxidative resynthesis 1,2 . Because of this, tissue PCO 2 monitoring can give information about tissue oxygen debt.…”

Section: Introductionmentioning

confidence: 99%

“…Local tissue partial pressures of CO 2 (PCO 2 ) increase when local cellular adenosine triphosphate use exceeds its rate of oxidative resynthesis. 1,2 Because of this, tissue PCO 2 monitoring can give information about tissue oxygen debt. Since CO 2 is a relatively freely diffusible gas that is not difficult to measure, it would be clinically convenient if there were a specific, accessible tissue that reliably developed a rising buffer-origin PCO 2 before other tissues were significantly damaged by inadequate systemic blood flow.…”

Section: Introductionmentioning

confidence: 99%

Non‐equivalence of canine tissue and intraluminal PCO₂ responses at different sites during hemorrhage and during resuscitation

Wall

Davis

Buising

et al. 2008

J Vet Emergen Crit Care

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Objective: The purpose of this study was to measure and compare the hemorrhage and resuscitation partial pressure of CO2 (PCO2) responses at a variety of sites, predominantly intraluminal gastrointestinal, in the same dog and among different dogs. Design: Observational study. Setting: Association for Assessment and Accreditation of Laboratory Animal Care accredited research laboratory. Animals: Pound source mongrel dogs being used in 4 separate hemorrhage and resuscitation studies, the objectives of which were unaffected by the PCO2 monitoring. Interventions: Fiber‐optic PCO2 monitoring systems were used to simultaneously monitor subcutaneous (n=8), sublingual (n=8) PCO2, and intraluminal esophageal (n=10), gastric (n=27), duodenal (n=16), jejunal (n=8), and ileal (n=7) PCO2 of 28 dogs used in 4 hemorrhage and resuscitation studies. Measurements and main results: The tissue or intraluminal PCO2 at all sites increased in response to hemorrhage. The rate and magnitude of esophageal, gastric, duodenal, jejeunal, and ileal intraluminal PCO2 varied widely between dogs for the same site and between sites in the same dog. Different gastrointestinal sites also responded differently to resuscitation. The rate and magnitude of changes in subcutaneous and sublingual PCO2 values were lower than those in the other tissues examined. The mean and maximum coefficients of variation for each site were as follows: subcutaneous 9%, 31%; sublingual 10%, 23%; esophageal 15%, 40%; gastric 26%, 90%; duodenal 25%, 70%; jejunal 25%, 95%; and ileal 34%, 87%. Conclusions: At different tissue sites, PCO2 values do not respond equivalently to either hemorrhage or resuscitation. One site cannot, therefore, be reliably used to indicate the energy status of an alternate site.

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Detection of ischemia by Pco2 before adenosine triphosphate declines in skeletal muscle

Cited by 15 publications

References 39 publications

Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia

Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia

Lowering of elevated tissue PCO₂in a hemorrhagic shock rat model after reinfusion of a novel nanobiotechnological polyhemoglobin-superoxide dismutase-catalase-carbonic anhydrase that is an oxygen and a carbon dioxide carrier with enhanced antioxidant properties

Non‐equivalence of canine tissue and intraluminal PCO₂ responses at different sites during hemorrhage and during resuscitation

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Detection of ischemia by Pco2 before adenosine triphosphate declines in skeletal muscle

Cited by 15 publications

References 39 publications

Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia

Tissue gas tensions and tissue metabolites for detection of organ hypoperfusion and ischemia

Lowering of elevated tissue PCO2in a hemorrhagic shock rat model after reinfusion of a novel nanobiotechnological polyhemoglobin-superoxide dismutase-catalase-carbonic anhydrase that is an oxygen and a carbon dioxide carrier with enhanced antioxidant properties

Non‐equivalence of canine tissue and intraluminal PCO2 responses at different sites during hemorrhage and during resuscitation

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Lowering of elevated tissue PCO₂in a hemorrhagic shock rat model after reinfusion of a novel nanobiotechnological polyhemoglobin-superoxide dismutase-catalase-carbonic anhydrase that is an oxygen and a carbon dioxide carrier with enhanced antioxidant properties

Non‐equivalence of canine tissue and intraluminal PCO₂ responses at different sites during hemorrhage and during resuscitation