Quantitative Mechanistic Modeling of Sublingual PCO2 as an Index of Severity and Resuscitation Success

Abstract

The goal of our task for the first year was to investigate whether the changes in sublingual PCO2 reflect changes in tissue blood flow during hemorrhage and hemorrhagic shock. Hemorrhagic shock was induced by a modification of Wigger's method in male domestic pigs weighting 35 to 40 kg. Sublingual PCO2 increased from 60 to 129 mmHg in parallel with average decreases in cardiac output to 44% and mean arterial pressure to 47% decreases in EtCO2 from 35 to 28 mmHg together with increases in arterial blood lactate concentrations from 0.7 to 7.8 mmol/l over the two-hour interval of shock. Utilizing colored microspheres for measurements, siblingual blood flow decreased to 34% liver flow to 56% and renal flow to 47%. After reinfusion of shed blood, sublingual PCO2 was restored to approximately baseline values together with arterial pressure, cardiac output and EtCO2, but there was delayed reversal of lactic acidosis. In control animals, no significant changes were observed over the same time interval. Increases in sublingual PCO2, is accompanied by proportionate decreases in sublingual and vital organ blood flows. Our study supports the rationale for non-invasive measurements of sublingual PCO2 for diagnosis and quantitation of the severity of hemorrhagic shock.

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Document Details

Document Type
Technical Report
Publication Date
Sep 01, 2003
Accession Number
ADA417675

Entities

People

  • Max H. Weil

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Acid-Base Imbalance
  • Arteries
  • Blood
  • Blood Flow
  • Cardiovascular Diseases
  • Cardiovascular Physiological Phenomena
  • Health Services
  • Hemorrhage
  • Hemorrhagic Shock
  • Intervals
  • Measurement
  • Microspheres
  • Patient Care
  • Shock (Pathology)
  • Veins

Fields of Study

  • Medicine

Readers

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  • Trauma Surgery or Emergency Medicine.