Measurement of Gastrointestinal Intramucosal pH Is a Poor Guide to Tolerable Levels of Anemia During Isovolemic Hemodilution in a Canine Model of Coronary Stenosis

Layland, Michael; Mythen, Michael G.; Wang, Kuo‐Yang; Albaladéjo, Pierre; Leone, Bruce J.

doi:10.1001/archsurg.1997.01430290093019

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…32 Finally, Layland et al showed that intramucosal pH was maintained during normovolemic hemodilution, despite reaching hemoglobin of 8.2 Ϯ 1.4 g/dL. 33 However, no previous study has specifically addressed the issue of ⌬PCO 2 behavior in supply dependency-induced hemodilution.…”

Section: Intramucosal-arterial Pco 2 Gap In Anemic Hypoxiamentioning

confidence: 99%

Intramucosal-Arterial Pco2 Gradient Does Not Reflect Intestinal Dysoxia in Anemic Hypoxia

Dubin

Bakker

Murias

et al. 2004

The Journal of Trauma: Injury, Infection, and Critical Care

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Section: Intramucosal-arterial Pco 2 Gap In Anemic Hypoxiamentioning

confidence: 99%

Intramucosal-Arterial Pco2 Gradient Does Not Reflect Intestinal Dysoxia in Anemic Hypoxia

Dubin

Bakker

Murias

et al. 2004

The Journal of Trauma: Injury, Infection, and Critical Care

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“…An increase in C02 partial pressure is considered to indicate splanchnic hypoperfusion. During normovolemic haemodilution, however, splanchnic and gastric perfusion actually increases [13-151 and Layland et al [16] have shown that in dogs with one coronary stenosis, myocardial ischemia occurs at higher haemoglobin levels than gastrointestinal intramucosal acidosis. Gastric tonometry thus may not be ideally suited to monitor the adequacy of 0 2 delivery during haemodilution and acute anaemia.…”

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confidence: 99%

Monitoring of Oxygen Delivery in Cardiac and Vascular Surgery

Spahn¹

1998

Vox Sanguinis

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Monitoring the adequacy of oxygen (O2) delivery is of paramount significance in the perioperative period of surgical patients undergoing cardiac and major vascular surgery. These patients are at considerable risk for ischemic perioperative complications due to a high incidence of coronary artery disease. Monitoring the adequacy of global O2 delivery is based on observing stability of haemodynamics, absence of elevated lactate levels and preservation of O2 consumption. Monitoring the adequacy of regional O2 delivery focuses on the coronary, cerebral, splanchnic and renal circulation. Myocardial ischemia can be detected relatively easily by continuous ECG monitoring of leads II and V5 and in selected cases by transesophageal echocardiography. There are relatively few monitoring modalities clinically available at the present time to reliably assess adequacy of O2 delivery in the cerebral, splanchnic and renal circulation. Expecting relatively low intra- and postoperative haemoglobin levels per se does not necessarily mandate greatly exaggerated monitoring. However, continuous ECG monitoring of leads II and V5, invasive blood pressure measurement, determination of hourly urine production may be indicated in most patients. In high risk patients extended monitoring with a pulmonary artery catheter and transesophageal echocardiography may be indicated. Most important, however, is the clinical surveillance by an experienced physician integrating the information of all applied monitoring modalities who realizes early alterations indicating (potentially) compromised O2 delivery.

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Blood-saving techniques with special emphasis on haemodilution

Spahn

Jamnicki

1998

Current Anaesthesia & Critical Care

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Measurement of Gastrointestinal Intramucosal pH Is a Poor Guide to Tolerable Levels of Anemia During Isovolemic Hemodilution in a Canine Model of Coronary Stenosis

Cited by 6 publications

References 24 publications

Intramucosal-Arterial Pco2 Gradient Does Not Reflect Intestinal Dysoxia in Anemic Hypoxia

Intramucosal-Arterial Pco2 Gradient Does Not Reflect Intestinal Dysoxia in Anemic Hypoxia

Monitoring of Oxygen Delivery in Cardiac and Vascular Surgery

Blood-saving techniques with special emphasis on haemodilution

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