Increased gastric-end tidal PCO2 gap during exercise at high altitude measured by gastric tonometry

High Altitude Medicine and Biology

Volumn 8, Issue 1, 2007, Pages 50-55

  Martin, Daniel S ^a,g   Mccorkell, Stuart ^b   Vercueil, Andre ^c   Gunning, Paul ^d   Cox, Mark ^e   Dick, John ^a   Mythen, Monty ^f   Grocott, Mike ^a  

^a UNIVERSITY COLLEGE LONDON   (United Kingdom)

^b ST THOMAS HOSPITAL   (United Kingdom)

^c KING S COLLEGE HOSPITAL   (United Kingdom)

^d CHARING CROSS HOSPITAL   (United Kingdom)

^e CHELSEA AND WESTMINSTER HOSPITAL   (United Kingdom)

^f UNIVERSITY COLLEGE LONDON   (United Kingdom)

^g ROYAL FREE AND UNIVERSITY COLLEGE MEDICAL SCHOOL   (United Kingdom)

Author keywords

Carbon dioxide; Exercise at high altitude; Gastric tonometry; Intestinal blood flow; Mucosal perfusion

Indexed keywords

ADULT; ALTITUDE; ARTICLE; AUTOMATION; CALCULATION; CARBON DIOXIDE TENSION; END TIDAL CARBON DIOXIDE TENSION; EXERCISE; HUMAN; HUMAN EXPERIMENT; INTESTINE BLOOD FLOW; NEPAL; NORMAL HUMAN; OBSERVATIONAL STUDY; PRIORITY JOURNAL; PROSPECTIVE STUDY; STOMACH; STOMACH MUCOSA; TONOMETRY; VOLUNTEER;

ADULT; CARBON DIOXIDE; EXERCISE; GASTRIC MUCOSA; HUMANS; MALE; MANOMETRY; MONITORING, PHYSIOLOGIC; OXYGEN CONSUMPTION; REFERENCE VALUES; REGRESSION ANALYSIS; TIDAL VOLUME;

EID: 34247155369     PISSN: 15270297     EISSN: None     Source Type: Journal    
DOI: 10.1089/ham.2006.1022     Document Type: Article

References (30)

1. Antonsson J.B., Boyle C.C. III, Kruithoff K.L., Wang H.L., Sacristan E., Rothschild H.R., and Fink M.P. (1990). Validation of tonometric measurement of gut intramural pH during endotoxemia and mesenteric occlusion in pigs. Am. J. Physiol. Gastrointest. Liver Physiol. 259:G519-G523.
2. Boyer S.J., and Blume F.D. (1984). Weight loss and changes in body composition at high altitude. J. Appl. Physiol. 57:1580-1585.
3. Calbet J. A. (2000). Oxygen tension and content in the regulation of limb blood flow. Acta Physiol. Scand. 168:465-472.
4. Carrico C.J., Meakins J.L., Marshall J.C., Fry D., and Maier R.V. (1986). Multiple organ failure syndrome. The gastrointestinal tract. The "motor" of MOF. Arch. Surg. 121:196-208.
5. Chapman M.V., Mythen M.G., Webb A.R., and Vincent J.L. (2000). Report from the meeting: gastrointestinal tonometry: state of the art. 22nd-23rd May 1998, London. Intensive Care Med. 26:613-622.
6. Dinmore A.J., Edwards J.S., Menzies I.S., and Travis S.P. (1994). Intestinal carbohydrate absorption and permeability at high altitude (5,730 m). J. Appl. Physiol. 76:1903-1907.
7. Dubin A., Murias G., Estenssoro E., Canales H., Badie J., Pozo M., Sottile J.P., Baran M., Palizas F., and Laporte M. (2002). Intramucosal-arterial PCO2 gap fails to reflect intestinal dysoxia in hypoxic hypoxia. Crit. Care 6:514-520.
8. Grum C.M., Fiddian-Green R.G., Pittenger G.L., Grant B.J., Rothman E.D., and Dantzker D.R. (1984). Adequacy of tissue oxygenation in intact dog intestine. J. Appl. Physiol. 56:1065-1069.
9. Gutierrez G., Palizas F., Doglio G., Wainsztein N., Gallesio A., Pacin J., Dubin A., Schiavi E., Jorge M., and Pusajo J. (1992). Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 339:195-199.
10. Heard S.O. (2003). Gastric tonometry: the hemodynamic monitor of choice (Pro). Chest 123:469S-474S.
11. CO2 in exercise. J. Appl. Physiol. 47:954-960.
12. Jutley R.S., Johnston R., Watt S.J., and Phull P.S. (2002). Acute ischaemic gastritis - an unrecognized hypoxic phenomenon at extreme altitude? Wilderness Environ. Med. 13:234-235.
13. CO2 during exercise is indicative of gastric ischaemia: a tonometric study. Gut. 44:163-167.
14. CO2 tonometry: an update on physiology, methodology and clinical applications. Br. J. Anaesth. 84:74-86.
15. Krejci V., Hiltebrand L., Banic A., Erni D., Wheatley A.M., and Sigurdsson G.H. (2000). Continuous measurements of microcirculatory blood flow in gastrointestinal organs during acute haemorrhage. Br. J. Anaesth. 84:468-475.
16. Krogh A., and Lindhard J. (1912). The regulation of the supply of blood to the right heart. Scand. Arch. Physiol. 27:227-248.
17. Larson M.V., Ahlquist D.A., Karlstrom L., and Sarr, M.G. (1994). Intraluminal measurement of enteric mucosal perfusion: relationship to superior mesenteric artery flow during basal and postprandial states in the dog. Surgery. 115:118-126.
18. Lebuffe G., Decoene C., Pol A., Prat A., and Vallet, B. (1999). Regional capnometry with air-automated tonometry detects circulatory failure earlier than conventional hemodynamics after cardiac surgery. Anesth. Analg. 89:1084-1090.
19. Moses F.M. (1990). The effect of exercise on the gastrointestinal tract. Sports Med. 9:159-172.
20. Mythen M.G., and Webb, A.R. (1995). Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch. Surg. 130:423-429.
21. Nieuwenhuijzen G.A., and Goris R.J. (1999). The gut: the "motor" of multiple organ dysfunction syndrome? Curr. Opinion Clin. Nutr. Metab. Care 2:399-404.
22. Otte J.A., Oostveen E., Geelkerken R.H., Groeneveld A.B., and Kolkman J.J. (2001). Exercise induces gastric ischemia in healthy volunteers: a tonometry study. J. Appl. Physiol. 91:866-871.
23. Pattinson K., Myers S., and Gardner-Thorpe, C. (2004). Problems with capnography at high altitude. Anaesthesia. 59:69-72.
24. Perko M.J., Nielsen H.B., Skak C., Clemmesen J.O., Schroeder T.V., and Secher, N.H. (1998). Mesenteric, coeliac and splanchnic blood flow in humans during exercise. J. Physiol. 513(Pt 3):907-913.
25. Riddoch C., and Trinick, T. (1988). Gastrointestinal disturbances in marathon runners. Br. J. Sports Med. 22:71-74.
26. Rokyta R. Jr., Matejovic M., Novak I., Zeman V., Krouzecky A., Novak J., Trefil L., Linhartova K, and Sramek V. (2002). Submaximal exercise in healthy volunteers: the relationship between gastric mucosal and systemic energy status. Pflugers Arch. 443:852-857.
27. Rowell L.B., Blackmon J.R., and Bruce R.A. (1964). Indocyanine green clearance and estimated hepatic blood flow during mild to maximal exercise in upright man. J. Clin. Invest. 43:1677-1690.
28. Stringer W.W., Hansen J.E., and Wasserman, K. (1997). Cardiac output estimated noninvasively from oxygen uptake during exercise. J. Appl. Physiol. 82:908-912.
29. CO2 difference as a continuous indicator of splanchnic perfusion. Br. J. Anaesth. 85:563-569.
30. Wasserman K., Hansen J.E., Sue D.Y., Stringer W., and Whipp B.J. (2005). Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications, 4th ed. Lippincott Williams & Wilkins, Philadelphia.