Evaluation of Subcutaneous Tissue Gases and pH during Induction of Acidosis and Alkalosis

Mellström, Å.; Jedlinska, Barbara; Hartmann, Michael; Jonsson, Kjell

doi:10.1159/000049696

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…P sc O 2 returned to baseline. However, only after the stabilization period of 30 min were the subcutaneous and intestinal intramucosal pH restored, corresponding to a very slow correction of oxygen metabolism as previously reported [34] . A contributory factor to the slow restoration of subcutaneous and intestinal pH might be the anesthesia per se , which contributes to a decrease in tissue oxygen tension as observed in the control animals when P sc O 2 decreased from 88 to 68 mm Hg while temperature stayed constant.…”

Section: Discussionsupporting

confidence: 71%

“…A contributory factor to the slow restoration of subcutaneous and intestinal pH might be the anesthesia per se , which contributes to a decrease in tissue oxygen tension as observed in the control animals when P sc O 2 decreased from 88 to 68 mm Hg while temperature stayed constant. The extent of the operative trauma also seems to have an impact on the level of P sc O 2 [34][35][36] . The baseline value of pH sc in this study was 7.37, which is slightly lower than the very consistent baseline value recorded in previous reports [31,32,34,37] .…”

Section: Discussionmentioning

confidence: 99%

“…The extent of the operative trauma also seems to have an impact on the level of P sc O 2 [34][35][36] . The baseline value of pH sc in this study was 7.37, which is slightly lower than the very consistent baseline value recorded in previous reports [31,32,34,37] . This difference might be related to the slightly higher lactate levels in this study or attributed to carbon dioxide production in the lumen of the gut by bacterial fermentation [32] .…”

Section: Discussionmentioning

confidence: 99%

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Measurements of Subcutaneous Tissue PO<sub>2</sub> Reflect Oxygen Metabolism of the Small Intestinal Mucosa during Hemorrhage and Resuscitation

et al. 2009

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Background: The first tissues to be deprived of perfusion and oxygenation in a hypovolemic situation and the last ones to be reperfused are the subcutaneous tissue and the gastrointestinal mucosa. We hypothesized that measurements of subcutaneous tissue gases and pH might reflect simultaneous changes in oxygenation of the intestinal mucosa. The aim of this study was to evaluate tissue gases and pH as measures of tissue oxygenation and tissue oxygen metabolism in subcutaneous and intestinal tissues simultaneously. Material and Methods: Five out of 17 domestic pigs (weight 21–25 kg) were used as controls without bleeding. Twelve animals were bled in 3 steps, 10% of their calculated blood volume at each step. The removed blood, crystalloid and colloid were thereafter infused, and animals were stabilized for 30 min. Measurements were made after each step of bleeding, retransfusion and stabilization. Before bleeding, all animals had a sensor (Paratrend 7™) implanted subcutaneously in the left groin for measurements of tissue gases and pH (P_scO₂, P_scCO₂ and pH_sc). Catheters were positioned in the jugular vein, portal vein, carotid artery, pulmonary artery and femoral artery for infusion, bleeding and oxygen monitoring. Via a midline laparotomy, 2 silicon tonometers (TRIP™ sigmoid catheters) were positioned in the ileum and sigmoid colon for measurements of PCO₂ and pH (P_iICO₂, P_siCO₂, pH_iI and pH_si). Blood flow in the portal vein was measured by an ultrasound probe (H6SB) and a Clark electrode (Cardiff tissue oxymeter) was used for serosal PO₂ measurements of the ileum (P_iIO₂) and sigmoid colon (P_siO₂). Results: After the first step of bleeding, P_scO₂ decreased from 64 ± 17 to 56 ± 22 mm Hg (SD; p < 0.05). P_scCO₂ and pH_sc did not change. P_iICO₂ increased from 64 ± 14 to 79 ± 14 mm Hg (p < 0.05), P_siCO₂ increased from 77 ± 16 to 90 ± 18 mm Hg (p < 0.05). pH_iI decreased from 7.15 ± 0.09 to 7.03 ± 0.09 (p < 0.05). P_iIO₂ and P_siO₂ decreased, but not significantly until steps of further bleeding. After re-transfusion and stabilization, P_scO₂ and P_iICO₂ returned to baseline. Conclusion: Measurements of subcutaneous PO₂ are sensitive to bleeding and resuscitation and reflect oxygen metabolism in the small intestinal mucosa as measured by PCO₂ and pH.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Measurements of Subcutaneous Tissue PO<sub>2</sub> Reflect Oxygen Metabolism of the Small Intestinal Mucosa during Hemorrhage and Resuscitation

et al. 2009

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Biomarker monitoring and long-acting insulin treatment in a stress model to facilitate personalized diabetic control

Jin

Burgess

2021

Journal of Controlled Release

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Influence of Positive End-Expiratory Pressure Ventilation on Peripheral Tissue Perfusion Evaluated by Measurements of Tissue Gases and pH

Jedlinska

Mellström²,

Jonsson³

et al. 2000

Eur Surg Res

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Measurements of subcutaneous oxygen tension (PscO₂), subcutaneous carbon dioxide tension (PscCO₂) and subcutaneous pH (pHsc) were used for evaluation of peripheral oxygenation in pigs subjected to oleic acid-induced lung injury during ventilation with increasing levels of positive end-expiratory pressure (PEEP). Lung injury resulted in a decrease of arterial oxygen tension (PaO₂) from 93 to 37 mm Hg (p < 0.01) with maintained cardiac output. PscO₂ decreased from 45 to 17 mm Hg (p < 0.01) and pHsc from 7.47 to 7.39 (p < 0.05), and PscCO₂ increased from 46 to 59 mm Hg (p < 0.05). Increase of PEEP level between 5 and 20 cm H₂O resulted in a continuous increase of PaO₂ from 45 to 145 mm Hg and a decrease of cardiac output from 4.1 to 2.0 liters/min (p < 0.01). PscO₂ increased up to a PEEP level of 15 cm H₂O, reaching 26 mm Hg. Further increase of PEEP level up to 20 cm H₂O resulted in an increase of PscCO₂ from 65 to 71 mm Hg (p < 0.05) and a decrease of pHsc from 7.31 to 7.29 (p < 0.05). In conclusion: measurements of tissue gases and pH can be used to evaluate optimum peripheral tissue oxygenation during titration of PEEP level. Whether these measurements can be used as the only indicator to guide therapy in an individual case remains to be studied.

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Evaluation of Subcutaneous Tissue Gases and pH during Induction of Acidosis and Alkalosis

Cited by 4 publications

References 22 publications

Measurements of Subcutaneous Tissue PO<sub>2</sub> Reflect Oxygen Metabolism of the Small Intestinal Mucosa during Hemorrhage and Resuscitation

Measurements of Subcutaneous Tissue PO<sub>2</sub> Reflect Oxygen Metabolism of the Small Intestinal Mucosa during Hemorrhage and Resuscitation

Biomarker monitoring and long-acting insulin treatment in a stress model to facilitate personalized diabetic control

Influence of Positive End-Expiratory Pressure Ventilation on Peripheral Tissue Perfusion Evaluated by Measurements of Tissue Gases and pH

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