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

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

doi:10.1159/000008769

Cited by 11 publications

(11 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After lung injury decreased lung compliance does not primarily allow the airways pressure to influence venous return. Improved ventilation-perfusion ratio normally results in an improved arterial oxygenation [15,18,20]. This was also found in this study, where arterial oxygenation continued to increase during the whole experiment.…”

Section: Discussionsupporting

confidence: 86%

“…Central haemodynamic variables and values of subcutaneous tissue gases and pH have previously been published [20].…”

Section: Resultsmentioning

confidence: 99%

“…The Paratrend 7 TM monitoring system (Biomedical Sensors, Shiley, High Wycombe, UK) has previously been described [19][20][21]. Briefly: the single-use sensor contains a modified Clark electrode for PO 2 measurements and two optodes for PCO 2 and pH measurements and a thermocouple for temperature measurements.…”

Section: Subcutaneous Tissue Gases and Phmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Splanchnic Perfusion and Oxygenation during Positive End-Expiratory Pressure Ventilation in Relation to Subcutaneous Tissue Gases and pH

Jedlinska

Mellström²,

Månsson³

et al. 2001

Eur Surg Res

Self Cite

View full text Add to dashboard Cite

Evaluation of splanchnic perfusion and oxygenation was performed by measurements of serosal tissue oxygen tension (PserO₂) and intramucosal pH (pHi) in relation to subcutaneous oxygen tension (PscO₂), subcutaneous carbon dioxide tension (PscCO₂) and subcutaneous pH (pHsc) 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 general hypoxia and redistribution of perfusion away from the subcutaneous and splanchnic tissues, illustrated by a decrease in PaO₂ from 93 to 37 mm Hg (p < 0.01), PscO₂ from 45 to 17 mm Hg (p < 0.01), PserO₂ from 80 to 30 mm Hg (p < 0.01) and pHi from 6.84 to 6.74 (p < 0.05) and a decrease of porta flow from 0.77 to 0.57 l/min. Application of PEEP up to 10–15 cm H₂O resulted in an increase of portal vein oxygen tension (PportaO₂) from 21 to 34 mm Hg (p < 0.01), PscO₂ from 17 to 26 mm Hg (p < 0.05) and PserO₂ from 30 to 55 mm Hg (p < 0.05). At PEEP 20 cm H₂O PserO₂ decreased to 47 mm Hg (p < 0.05). Porta flow decreased continuously with increasing levels of PEEP. PserO₂ correlated with PportaO₂ (r = 0.7, p < 0.001). pHi correlated poorly with PportaO₂ (r = 0.2) and porta flow (r = 0.4). PscO₂ and PserO₂ correlated well (r = 0.8, p < 0.001). In summary, splanchnic perfusion and oxygenation was better reflected by serosal oxygen tension than pHi in the colon. Changes in serosal oxygenation of the colon paralleled changes in subcutaneous tissue oxygenation.

show abstract

Section: Discussionsupporting

confidence: 86%

“…Central haemodynamic variables and values of subcutaneous tissue gases and pH have previously been published [20].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Splanchnic Perfusion and Oxygenation during Positive End-Expiratory Pressure Ventilation in Relation to Subcutaneous Tissue Gases and pH

Jedlinska

Mellström²,

Månsson³

et al. 2001

Eur Surg Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…The value in the present study is about 5 mm Hg higher than in the previous study. Furthermore in a study on the effect of positive end-expiratory pressure ventilation the baseline value of P sc O 2 was 45 mm Hg when P a O 2 was 93 mm Hg [24]. In the latter study the animals had a more extensive preparation including laparotomy.…”

Section: Discussionmentioning

confidence: 99%

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

Mellström

Jedlinska²,

Hartmann³

et al. 2001

Eur Surg Res

Self Cite

View full text Add to dashboard Cite

Peripheral tissue oxygen utilization was studied during hypoxic-induced acidosis and sodium bicarbonate-induced alkalosis in 8 domestic pigs by measurements of subcutaneous oxygen tension (P_scO₂), carbon dioxide tension (P_scCO₂) and pH (pH_sc) in relation to central hemodynamic parameters and oxygenation. Hypoxic-induced acidosis resulted in a decrease in P_scCO₂ and arterial oxygen tension (P_aO₂) to one third of baseline values (p < 0.05), an increase in P_scCO₂ and arterial carbon dioxide tension (P_aCO₂) from 41 to 55 and 34 to 39 mm Hg, respectively (p < 0.05), and a decrease in pH_sc from 7.47 to 7.30 (p < 0.05). P_scO₂ and P_aO₂ increased during reversal of hypoxia and infusion of bicarbonate (p < 0.05), without reaching baseline values. In parallel P_scCO₂ decreased and pH_sc increased but changes lagged behind changes in blood gases. Alkalosis established by further infusion of bicarbonate resulted in a decrease in P_aO₂ to 62 mm Hg whereas P_scO₂ remained below baseline values (p < 0.05). Correction of oxygen utilization in the subcutaneous tissue as measured by the markers P_scCO₂ and pH_sc is slower than indicated by changes in tissue oxygen tension, blood gases and pH. Overcompensation of acidosis with bicarbonate resulting in alkalosis impairs oxygenation.

show abstract

“…Venous access opening pressure, so that titration of mechanical ventilation parameters is necessary. (2) Due to the complexity of its pathophysiology and to interactions in other systems, especially the cardiovascular system, ALI is the object of study in various fields of medical science. The animal models most commonly used in order to induce ALI are as follows: bronchoalveolar lavage with saline solution; intraperitoneal administration of paraquat; ischemia and reperfusion; and administration of oleic acid (OA) to the nervous system.…”

Section: Preparation Of the Animalsmentioning

confidence: 99%

Estabilidade do modelo animal de lesão pulmonar aguda induzida por ácido oleico

Gaio

Silva

Brito³

et al. 2009

J. bras. pneumol.

View full text Add to dashboard Cite

Objective: To evaluate the stability of hemodynamic, respiratory and gas exchange variables in an animal model of oleic acid-induced acute lung injury. Methods: This was an experimental study involving 10 mongrel dogs. The variables were measured at baseline, as well as at 30, 60, 90 and 120 min after the administration of oleic acid. In order to analyze repeated measurements, linear and quadratic effects were tested. Mixed linear models with diversified variance and covariance structures were used, depending on the variable studied. Results: We found that mean arterial blood pressure stabilized at 30 min, as did heart rate, pulmonary arterial pressure and pulmonary capillary pressure at 60 min. Respiratory rate, tidal volume, minute volume and respiratory work stabilized at 30 min. Regarding gas exchange variables, PaO 2 , PaO 2 /FiO 2 ratio and pulmonary shunt fraction stabilized at 30 min. The remaining variables maintained a continuous rise or fall. Conclusions: This oleic acid-induced acute lung injury model is stable for some of the variables tested, although stabilization occurs at different times. The respiratory and gas exchange variables stabilized at 30 min, whereas the hemodynamic variables stabilized at 60 min. Keywords:Respiratory distress syndrome, adult; Models, animal; Statistical analysis. ResumoObjetivo: Avaliar a estabilidade das variáveis hemodinâmicas, da mecânica respiratória e de troca gasosa do modelo animal de lesão pulmonar aguda induzida por ácido oleico. Métodos: Trata-se de um estudo experimental no qual foram utilizados 10 cães de raça indeterminada. As variáveis foram aferidas inicialmente e em 30, 60, 90 e 120 min após a administração do ácido oleico. Para analisar as medidas repetidas, foram testados efeitos lineares e quadráticos e foram utilizados ajustes de modelos lineares mistos com estruturas de variâncias e covariâncias diversificadas, dependendo da variável analisada. Resultados: Observamos estabilidade da pressão arterial média aos 30 min, assim como da frequência cardíaca, da pressão arterial pulmonar e da pressão de capilar pulmonar aos 60 min. Frequência respiratória, volume corrente, volume minuto e trabalho respiratório estabilizaram aos 30 min. Quanto às variáveis de troca gasosa, PaO 2 , relação PaO 2 /FiO 2 e fração de shunt pulmonar estabilizaram-se aos 30 min. As demais variáveis mantiveram-se em ascensão ou queda contínuas. Conclusões: O modelo de lesão pulmonar aguda induzida por ácido oleico é estável para algumas das variáveis testadas; porém, a estabilização se dá em momentos diferentes. As variáveis da mecânica respiratória e de troca gasosa estabilizaram em 30 min, e as hemodinâmicas, em 60 min.Descritores: Síndrome do desconforto respiratório do adulto; Modelos animais; Análise estatística. *Study carried out in the

show abstract

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

Cited by 11 publications

References 39 publications

Evaluation of Splanchnic Perfusion and Oxygenation during Positive End-Expiratory Pressure Ventilation in Relation to Subcutaneous Tissue Gases and pH

Evaluation of Splanchnic Perfusion and Oxygenation during Positive End-Expiratory Pressure Ventilation in Relation to Subcutaneous Tissue Gases and pH

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

Estabilidade do modelo animal de lesão pulmonar aguda induzida por ácido oleico

Contact Info

Product

Resources

About