Assessment of intestinal and renal perfusion using surface oximetry.
Using a miniaturized polarographic oxygen sensor, we studied the sequential effects of graded hypoxia and standardized hemorrhagic shock on organ surface oxygen tension (PsO2) measurements obtained from the canine small intestine and kidney. During hypoxia, intestinal and renal PsO2 values decreased along with PaO2. The weighted mean correlation coefficients for intestinal and renal PsO2 vs. PaO2 were 0.94 and 0.98, respectively. During severe hypoxia, intestinal and renal PsO2 values fell by 55 +/- 8% and 55 +/- 7% (SEM), respectively, while oxygen delivery fell by 58 +/- 10% (SEM). During active hemorrhage, intestinal and renal PsO2 values decreased along with cardiac output, while PaO2 remained relatively constant. Intestinal and renal PsO2 values correlated with cardiac output during hemorrhage and reinfusion of the shed blood. Initially, intestinal PsO2 values fell more quickly than did renal PsO2; the latter decreased by approximately half as much as intestinal PsO2 after 15 and 30 ml/kg of blood loss. After a 45-ml/kg blood loss, however, the decreases in intestinal and renal PsO2 values were not significantly different from each other. During the terminal stage, cardiac output declined progressively, as did intestinal and renal PsO2 values, despite a relatively high PaO2. Overall, intestinal and renal PsO2 values tracked PaO2 during hypoxia, cardiac output during hemorrhage and reinfusion, and oxygen delivery during both conditions. Clinical and experimental experience indicates that organ PsO2 monitoring is potentially valuable for the intraoperative assessment of tissue perfusion and viability.
D000818:Animals; D004285:Dogs; D006470:Hemorrhage / Q000378:metabolism; D000860:Hypoxia / Q000378:metabolism*; D007421:Intestine, Small / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism*; D010092:Oximetry / Q000379:methods*; D010101:Oxygen Consumption; D012769:Shock / Q000378:metabolism