Splanchnic perfusion evaluation during hemorrhage and resuscitation with gastric near-infrared spectroscopy

J Trauma. 2001 Apr;50(4):629-34; discussion 634-5. doi: 10.1097/00005373-200104000-00006.

Abstract

Objective: The purpose of this study was to use a prototype side-illuminating near-infrared spectroscopy (NIRS) nasogastric probe to continuously measure changes in gastric tissue oxygen saturation (Sto2) in a pig hemorrhage model.

Methods: Swine (n = 12; 6 per group) underwent laparotomy and placement of a gastric NIRS probe, jejunal tonometer, superior mesenteric artery (SMA) flow probe, and a portal vein catheter. Animals underwent hemorrhage (28 mL/kg) t = 0 to 20 minutes (where t = time). Pigs in group I were resuscitated (t = 20-40 minutes) with lactated Ringer's solution (84 mL/kg), whereas group II had no resuscitation.

Results: A significant decrease in mean arterial pressure and SMA flow was observed after hemorrhage. SMA flow significantly correlated in group I with both NIRS Sto2 (r = 0.58, p = 0.0001) and regional CO2 (r = -0.54, p = 0.0001). In group II, superior mesenteric flow correlated with NIRS Sto2 (r = 0.30, p = 0.03), but not regional CO2 (r = -0.23, p = 0.09).

Conclusion: Direct measurement of tissue oxygen saturation with a prototype side-illuminating near-infrared spectroscopy gastric probe appeared to rapidly reflect changes in splanchnic perfusion.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Analysis of Variance
  • Animals
  • Blood Flow Velocity
  • Blood Gas Analysis
  • Blood Pressure
  • Disease Models, Animal*
  • Gastric Mucosa / blood supply*
  • Gastric Mucosa / chemistry*
  • Gastric Mucosa / metabolism
  • Intubation, Gastrointestinal
  • Isotonic Solutions
  • Jejunostomy
  • Jejunum / blood supply
  • Jejunum / chemistry
  • Jejunum / metabolism
  • Male
  • Monitoring, Physiologic / methods*
  • Oxygen / analysis*
  • Oxygen Consumption
  • Resuscitation* / methods
  • Ringer's Lactate
  • Shock, Hemorrhagic / diagnosis*
  • Shock, Hemorrhagic / metabolism*
  • Shock, Hemorrhagic / therapy
  • Spectroscopy, Near-Infrared / instrumentation
  • Spectroscopy, Near-Infrared / methods*
  • Spectroscopy, Near-Infrared / standards
  • Splanchnic Circulation*
  • Swine
  • Time Factors

Substances

  • Isotonic Solutions
  • Ringer's Lactate
  • Oxygen