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

Stephen M. Cohn; J. Esteban Varela; Giovanni Giannotti; Matthew O. Dolich; Margaret Brown; Ara Feinstein; Mark G. McKenney; Paul Spalding

doi:10.1097/00005373-200104000-00006

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

Stephen M. Cohn, J. Esteban Varela, Giovanni Giannotti, Matthew O. Dolich, Margaret Brown, Ara Feinstein, Mark G. McKenney, Paul Spalding

Surgery

Research output: Contribution to journal › Article › peer-review

55 Scopus citations

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.

Original language	English (US)
Pages (from-to)	629-635
Number of pages	7
Journal	Journal of Trauma - Injury, Infection and Critical Care
Volume	50
Issue number	4
DOIs	https://doi.org/10.1097/00005373-200104000-00006
State	Published - Jan 1 2001

Keywords

Hemorrhagic shock
Near-infrared spectroscopy
Resuscitation
Splanchnic perfusion

ASJC Scopus subject areas

Surgery
Critical Care and Intensive Care Medicine

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Splanchnic perfusion evaluation during hemorrhage and resuscitation with gastric near-infrared spectroscopy. / Cohn, Stephen M.; Varela, J. Esteban; Giannotti, Giovanni; Dolich, Matthew O.; Brown, Margaret; Feinstein, Ara; McKenney, Mark G.; Spalding, Paul.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 50, No. 4, 01.01.2001, p. 629-635.

Research output: Contribution to journal › Article › peer-review

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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.",

keywords = "Hemorrhagic shock, Near-infrared spectroscopy, Resuscitation, Splanchnic perfusion",

author = "Cohn, {Stephen M.} and Varela, {J. Esteban} and Giovanni Giannotti and Dolich, {Matthew O.} and Margaret Brown and Ara Feinstein and McKenney, {Mark G.} and Paul Spalding",

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AU - Giannotti, Giovanni

AU - Dolich, Matthew O.

AU - Brown, Margaret

AU - Feinstein, Ara

AU - McKenney, Mark G.

AU - Spalding, Paul

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N2 - 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.

AB - 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.

KW - Hemorrhagic shock

KW - Near-infrared spectroscopy

KW - Resuscitation

KW - Splanchnic perfusion

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