Application of fiberoptic sensors for the study of hepatic dysoxia in swine hemorrhagic shock
Application of fiberoptic sensors for the study of hepatic dysoxia in swine hemorrhagic shock
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DOI：
10.1097/00003246-200107000-00023
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发表时间：
2001-07
影响因子：
8.8
通讯作者：
B. Soller;S. Heard;N. Cingo;C. Hsi;J. Favreau;T. Khan;R. Ross;J. Puyana
中科院分区：
文献类型：
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作者：
B. Soller;S. Heard;N. Cingo;C. Hsi;J. Favreau;T. Khan;R. Ross;J. Puyana
目的确定用多参数光纤传感器同时测量组织pH、二氧化碳分压和氧分压是否可以用来预测肝脏缺氧的开始，确定临界值，并评估它们在预测阴性结果中的作用。设计前瞻性动物研究。设置大学研究实验室。研究对象14头约克郡猪。干预：失血性休克(n=11)在15分钟内将收缩压降至40毫米汞柱，并维持30、60或90分钟。复苏时用失血和温生理盐水维持平均压力&60 mm Hg120分钟。假手术组(n=3)给予90分钟假休克，然后恢复120分钟。测量和主要结果多参数传感器连续测量组织的pH值、二氧化碳分压和氧分压。无氧代谢指标PH值和二氧化碳分压(PCO2)与组织氧分压(PO2)作对比。所有休克动物，但没有假动物，显示了PO2与pH和PCO2之间的双相关系。曲线符合指数和双线线性函数，以确定PO2、pH和PCO2的临界值。动物缺氧的时间长短被评估为阴性结果的预测因子。指数模型确定的临界值比线性模型确定的临界值更敏感，也比动脉乳酸和眼压粘膜内pH和pCO2更敏感。结论该多参数传感器可同时测量组织间的pH值、二氧化碳分压和氧分压，为研究固体器官和中空器官的功能障碍提供了独特的机会。由出血引起的从充足氧气供应到体温异常的逐渐转变可用指数方程更好地描述。PH低于指数模型所确定的临界值或二氧化碳分压高于临界值的时间长度预示着负面结果。
ObjectivesTo determine whether the simultaneous measurement of tissue pH, Pco2, and Po2 with a multiple-parameter fiberoptic sensor can be used to indicate the onset of hepatic dysoxia, to determine critical values, and to assess their use in predicting negative outcomes. DesignProspective animal study. SettingUniversity research laboratory. SubjectsFourteen Yorkshire swine. InterventionsHemorrhagic shock (n = 11) was induced over 15 mins to lower systolic blood pressure to 40 mm Hg and was maintained for 30, 60, or 90 mins. Resuscitation was achieved with shed blood and warm saline to maintain mean pressure >60 mm Hg for 120 mins. Sham animals (n = 3) were subjected to 90 mins of sham shock, followed by a 120-min recovery period. Measurements and Main Results The multiple-parameter sensor continuously measured tissue pH, Pco2, and Po2. pH and Pco2, indicators of anaerobic metabolism, were plotted against tissue Po2. All shocked animals, but no sham animals, showed a biphasic relationship between Po2 and both pH and Pco2. Curves were fit to both an exponential and a dual-line linear function to determine critical values for Po2, pH, and Pco2. The length of time the animal was dysoxic was evaluated as a predictor of negative outcome. Critical values determined from the exponential models were more sensitive indicators of negative outcome than values determined from the linear model and more sensitive than arterial lactate and tonometric intramucosal pH and Pco2. ConclusionsThe multiple-parameter sensor offers the unique opportunity to study solid as well as hollow organ dysoxia through the simultaneous measurement of interstitial pH, Pco2, and Po2 in a small tissue region. The gradual transition from sufficient oxygen availability to dysoxia as a result of hemorrhage was better described by an exponential equation. The length of time that pH was below or Pco2 was above the critical value determined from the exponential model was predictive of a negative outcome.