The following is the abstract of the article discussed in the subsequent letter:
Letter 2005 en
Authors
CV
Colin Verdant
DB
Daniel De Backer
JC
Jacques Créteur
Abstract
1 min read
Sublingual and intestinal mucosal blood flow and Pco 2 were studied in a canine model of endotoxin-induced circulatory shock and resuscitation. Sublingual Pco 2 (Ps[Formula: see text]) was measured by using a novel fluorescent optrode-based technique and compared with lingual measurements obtained by using a Stowe-Severinghaus electrode [lingual Pco 2 (Pl[Formula: see text])]. Endotoxin caused parallel changes in cardiac output, and in portal, intestinal mucosal, and sublingual blood flow (Q̇ s ). Different blood flow patterns were observed during resuscitation: intestinal mucosal blood flow returned to near baseline levels postfluid resuscitation and decreased by 21% after vasopressor resuscitation, whereas Q̇ s rose to twice that of the preshock level and was maintained throughout the resuscitation period. Electrochemical and fluorescent Pco 2 measurements showed similar changes throughout the experiments. The shock-induced increases in Ps[Formula: see text] and Pl[Formula: see text] were nearly reversed after fluid resuscitation, despite persistent systemic arterial hypotension. Vasopressor administration induced a rebound of Ps[Formula: see text] and Pl[Formula: see text] to shock levels, despite higher cardiac output and Q̇ s , possibly due to blood flow redistribution and shunting. Changes in Pl[Formula: see text] and Ps[Formula: see text] paralleled gastric and intestinal Pco 2 changes during shock but not during resuscitation. We found that the lingual, splanchnic, and systemic circulations follow a similar pattern of blood flow variations in response to endotoxin shock, although discrepancies were observed during resuscitation. Restoration of systemic, splanchnic, and lingual perfusion can be accompanied by persistent tissue hypercarbia, mainly lingual and intestinal, more so when a vasopressor agent is used to normalize systemic hemodynamic variables.
Discussion(0)
No comments yet. Be the first to comment.