NDLI: Esophageal capnometry during hemorrhagic shock and after resuscitation in rats

Content Provider	Springer Nature : BioMed Central
Author	Totapally, Balagangadhar R Fakioglu, Harun Torbati, Dan Wolfsdorf, Jack
Abstract	Background Splanchnic perfusion following hypovolemic shock is an important marker of adequate resuscitation. We tested whether the gap between esophageal partial carbon dioxide tension (PeCO 2) and arterial partial carbon dioxide tension (PaCO 2) is increased during graded hemorrhagic hypotension and reversed after blood reinfusion, using a fiberoptic carbon dioxide sensor. Materials and method Ten Sprague–Dawley rats were anesthetized, tracheotomized, and cannulated in one femoral artery and vein. A calibrated fiberoptic PCO 2 probe was inserted into the distal third of the esophagus for determination of luminal PeCO 2 during maintained anesthesia (pentobarbital 15 mg/kg per hour), normothermia (38 ± 0.5°C), and fluid balance (saline 5 ml/kg per hour). Three out of 10 rats were used to determine the limits of hemodynamic stability during gradual hemorrhage. Seven of the 10 rats were then subjected to mild and severe hemorrhage (15 and 20–25 ml/kg, respectively). Thirty minutes after severe hemorrhage, these rats were resuscitated by reinfusion of the shed blood. Arterial gas exchange, hemodynamic variables, and PeCO 2 were recorded at each steady-state level of hemorrhage (at 30 and 60 min) and after resuscitation. Results The PeCO 2–PaCO 2 gap was significantly increased after mild and severe hemorrhage and returned to baseline (prehemorrhagic) values following blood reinfusion. Base deficit increased significantly following severe hemorrhage and remained significantly elevated after blood reinfusion. Significant correlations were found between base deficit and PeCO 2–PaCO 2 (P < 0.002) and PeCO 2 (P < 0.022). Blood bicarbonate concentration decreased significantly following mild and severe hemorrhage, but its recovery was not complete at 60 min after blood reinfusion. Conclusion Esophageal–arterial PCO 2 gap increases during graded hemorrhagic hypotension and returns to baseline value after resuscitation without complete reversal of the base deficit. These data suggest that esophageal capnometry could be used as an alternative for gastric tonometry during management of hypovolemic shock.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc1856.pdf
Ending Page	6
Page Count	6
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc1856
Journal	Critical Care
Issue Number	1
Volume Number	7
Language	English
Publisher	BioMed Central
Publisher Date	2002-12-20
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine esophageal luminal PCO 2 base deficit capnometry hemorrhagic hypotension hypovolemic shock tonometry
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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