Tugtekin, I. F. and Radermacher, Peter and Theisen, M. and Matejovic, M. and Stehr, A. and Ploner, F. and Matura, K. and Ince, C. and Georgieff, M. and Traeger, K. (2001) Increased ileal-mucosal-arterial PCO2 gap is associated with impaired villus microcirculation in endotoxic pigs. INTENSIVE CARE MEDICINE, 27 (4). pp. 757-766. ISSN 0342-4642
Full text not available from this repository. (Request a copy)Abstract
Objective:To investigate whether an increased ileal-mucosal-arterial PCO2 gap (Delta PCO2) during hyperdynamic porcine endotoxemia is associated with impaired villus microcirculation, Design: Prospective, randomized, controlled, experimental study. Setting: Animal research laboratory. Animals: Twenty-two domestic pigs. Interventions: After baseline measurements, anesthetized and ventilated pigs received continuous i.v. endotoxin (ETX, n = 12) for 24 h or placebo (SHAM, n = 10). Measurements and results: Before, as well as 12 and 24 h after, the start of endotoxin or saline portal venous blood now (Q,v, ultrasound flow probe) and lactate/pyruvate ratios (LIP), the ileal-mucosal-arterial Delta PCO2 (fiberoptic sensor) and bowel-wall capillary hemoglobin Or saturation (%Hb-O-2-cap, remission spectrophotometry) were assessed together with intravital video records of the ileal-mucosal microcirculation (number of perfused/heterogeneously perfused/unperfused villi) using orthogonal polarization spectral imaging (CYTOSCAN A/R) via an ileostomy At 12 and 24 h endotoxin infusion, about half of the evaluated villi were heterogeneously or unperfused which was paralleled by a progressive significant increase of the ileal-mucosal-arterial Delta PCO2: and portal venous LIP ratios? whereas Q(PV) as well as both the mean % Hb-O-2-cap and the %Hb-O-2-cap frequency distributions remained unchanged. By contrast, in the SHAM-group, mucosal microcirculation was well-preserved, and none of the other parameters were influenced. Conclusions: We conclude that an increased ileal-mucosal-arterial Delta PCO2 during porcine endotoxemia is related to impaired villus microcirculation. A putative contribution of disturbed cellular oxygen utilization resulting from ''cytopathic hypoxia" may also assume importance.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SPLANCHNIC BLOOD-FLOW; SEPTIC SHOCK; MICROVASCULAR PERFUSION; GASTROINTESTINAL-TRACT; NORMOTENSIVE SEPSIS; CAPILLARY DENSITY; PORCINE MODEL; IN-VIVO; DOBUTAMINE; RATS; endotoxin; ileal-mucosal-arterial PCO2 gap; orthogonal polarization spectral imaging lactate/pyruvate ratios; remission spectrophotometry; villus microcirculation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Feb 2022 10:22 |
| Last Modified: | 07 Feb 2022 10:22 |
| URI: | https://pred.uni-regensburg.de/id/eprint/41560 |
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