Gut mucosal-arterial PCO2 gradient as an indicator of splanchnic perfusion during systemic hypo- and hypercapnia

Critical Care Medicine

Volumn 27, Issue 12, 1999, Pages 2760-2765

  Guzman, Jorge A ^a   Kruse, James A ^a  

^a WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Acid base disturbances; Gastrointestinal tonometry; Hypercapnia; Hyperventilation; Hypocapnia; Hypoventilation; Intramucosa l PCO2; PCO2 gradient; Splanchnic perfusion

Indexed keywords

CARBON DIOXIDE;

ACID BASE BALANCE; ANIMAL EXPERIMENT; ANIMAL MODEL; ARTICLE; ARTIFICIAL VENTILATION; CAPNOGRAPHY; CARBON DIOXIDE MEASUREMENT; CARBON DIOXIDE TENSION; CONTROLLED STUDY; DOG; HYPERCAPNIA; HYPERVENTILATION; HYPOCAPNIA; INTRAVENOUS ADMINISTRATION; LUNG MINUTE VOLUME; NONHUMAN; PORTAL VEIN BLOOD FLOW; PRIORITY JOURNAL; SPLANCHNIC BLOOD FLOW; TONOMETRY;

EID: 0033373136     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/00003246-199912000-00026     Document Type: Article

References (39)

1. 1. Meakins JL, Marshall JC: The gut as the motor of multiple organ system failure. In: Splanchnic Ischemia and Multiple Organ Failure. Marston A, Bulkley GB, Fiddian-Green RG, et al (Eds). St Louis, CV Mosby, 1989. pp 339-348
2. 2. Deitch EA: The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure. Arch Surg 1990; 125:403-404
3. 3. Nieuwenhuijzen GAP, Deitch EA, Goris RJA: The relationship between gut-derived bacteria and the development of multiple organ dysfunction syndrome. J Anat 1996; 189: 537-548
4. 4. Antonsson JB, Boyle III CC, Kruithoff KL, et al: Validation of tonometric measurement of gut intramural pH during endotoxemia and mesenteric occlusion in pigs. Am J Physiol 1990; 259:G519-G523
5. 5. Fiddian-Green RG: Gastric intramucosal pH, tissue oxygenation and acid-base balance. Br J Anaesth 1995; 74:591-606
6. 6. Groeneveld ABJ, Kolkman JJ: Splanchnic tonometry: A review of physiology, methodology, and clinical applications. J Crit Care 1994; 9:198-210
7. 7. Kivilaakso EJ, Ahonen J, Aronsen KF, et al: Gastric blood flow, tissue gas tension and microvascular changes during hemorrhage-induced stress ulceration in the pig. Am J Surg 1982; 143:322-330
8. 8. Montgomery A, Hartmann M, Jonsson K, et al: Intramucosal pH measurement with tonometers for detecting gastrointestinal ischemia in porcine hemorrhagic shock. Circ Shock 1989; 29:319-327
9. 9. Gutierrez G, Palizas F, Doglio G, et al: Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 1992; 339:195-199
10. 10. Marik PE: Gastric intramucosal pH: A better predictor of multiorgan dysfunction syndrome and death than oxygen-derived variables in patients with sepsis. Chest 1993; 104:225-229
11. 11. Mohsenifar Z, Hay A, Hay J, et al: Gastric intramural pH as a predictor of success or failure in weaning patients from mechanical ventilation. Ann Intern Med 1993; 119: 794-798
12. 12. Gutierrez G, Bismar H, Dantzker DR, et al: Comparison of gastric intramucosal pH with measures of oxygen transport and consumption in critically ill patients. Crit Care Med 1992; 20:450-457
13. 13. Guzman JA, Kruse JA: Development and validation of a technique for continuous monitoring of gastric intramucosal pH. Am J Respir Crit Care Med 1996; 153:694-700
14. 2 and pH in hemorrhagic shock using capnometric recirculating gas tonometry. Crit Care Med 1997; 25:533-537
15. 2 in critically ill septic patients. Intensive Care Med 1997; 23:524-529
16. 16. Temmesfeld-Wollbrück B, Szalay A, Olschewsky H, et al: Advantage of buffered solutions or automated capnometry in air-filled balloons for use in gastric tonometry. Intensive Care Med 1997; 23:423-427
17. 17. Creteur J, De Backer D, Vincent J-L: Monitoring gastric mucosal carbon dioxide pressure using gas tonometry. Anesthesiology 1997; 87:504-510
18. 2 in intestine during low flow. J Appl Physiol 1994; 76:2443-2451
19. 2 difference is a better marker of ischemia than intramural pH (pHi) or arterial pH-pHi difference. J Crit Care 1996; 11:51-56
20. 20. Russell JA: Gastric tonometry: Does it work? Intensive Care Med 1997; 23:3-6
21. 21. Friedman G, Berlot G, Kahn RJ, et al: Combined measurements of blood lactate concentrations and gastric intramucosal pH in patients with severe sepsis. Crit Care Med 1995; 23:1184-1193
22. 22. Hamilton-Davies C, Mythen MG, Salmon JB, et al: Comparison of commonly used clinical indicators of hypovolaemia with gastrointestinal tonometry. Intensive Care Med 1997; 23:276-281
23. 2 gradients as indicators of hypoperfusion in a canine model of septic shock. Chest 1998; 113:1078-1083
24. 2 difference as a marker of systemic supply dependency. Abstr. Crit Care Med 1997; 25(Suppl):A69
25. 2 content: pK′ revisited. Clin Intensive Care 1995; 6:15-20
26. 2 content. J Appl Physiol 1988; 65:473-477
27. 27. Siggard-Andersen O, Wimberley PD, Göthgen I, et al: A mathematical model of the hemoglobin-oxygen dissociation curve of human blood and the partial oxygen pressure as a function of temperature. Clin Chem 1984; 30:1646-1651
28. 2 gradients. Chest 1997; 112(Suppl):4S
29. 29. Cullen J, Eger II EI: Cardiovascular effects of carbon dioxide in man. Anesthesiology 1974; 41:345-349
30. 30. Price HL: Effects of carbon dioxide on the cardiovascular system. Anesthesiology 1960; 21:652-663
31. 31. Nanas S, Magder S: Adaptations of the peripheral circulation to PEEP. Am Rev Respir Dis 1992; 146:688-693
32. 32. Fessler HE, Brower RG, Wise RA, et al: Effects of positive end-expiratory pressure on the gradient for venous return. Am Rev Respir Dis 1991; 143:19-24
33. 33. Woodson RD: Physiological significance of oxygen dissociation curve shifts. Crit Care Med 1979; 7:368-373
34. 34. Hlastala MP: Physiological significance of the interaction of oxygen and carbon dioxide in the blood. Crit Care Med 1979; 7:374-379
35. 2 diffusion. Am J Physiol 1987; 253:G527-G530
36. 36. Khambatta HJ, Sullivan SF: Effects of respiratory alkalosis on oxygen consumption and oxygenation. Anesthesiology 1973; 38:53-58
37. 37. Cain SM: Increased oxygen uptake with passive hyperventilation of dogs. J Appl Physiol 1970; 28:4-7
38. 38. Johnson ER: Splanchnic hemodynamic response to passive hyperventilation. J Appl Physiol 1975; 38:156-162
39. 39. Cohen RD, Woods HF: Clinical and Biochemical Aspects of Lactic Acidosis. London, Blackwell Scientific, 1976, pp 109-117