Continuous measurement of tissue oxygen and carbon dioxide gas tensions in dog liver in ischemia/reperfusion.
An experiment was conducted to determine whether the oxygen and carbon dioxide gas tensions in liver tissue (PtO2 and PtCO2, respectively) reflect the state of microcirculation and/or metabolism in the ischemic liver. Subjects were divided into three groups: group 1, 30 min ischemia; group 2, 60 min ischemia; group 3, four times of intermittent 15 min ischemia after every 10 min of reperfusion. PtO2, PtCO2 and tissue blood flow (TBF) were measured by mass spectrometry, comparatively studied with the serum GOT level as an indicator of liver tissue damage. Furthermore, the time point at which the PtCO2 increase for 1 min initially became less than 1/2 of the maximum value was located on the transit curve of PtCO2, referred to as the critically anaerobic (CA) point, with which new indices of critically anaerobic score (CAS) and time (CAT) (see details in text) were developed. The profiles of PtO2 and PtCO2 during ischemia and reperfusion were clearly demonstrated, and the CA point was observed 12.7 +/- 2.9 min after induction of ischemia. PtO2 was positively correlated with TBF and negatively with the serum GOT level. Furthermore, not only CAS but also CAT were significantly correlated with PtO2, TBF, and the serum GOT level. It was concluded that PtCO2 reflects the state of anaerobic tissue metabolism during ischemia and PtO2 reflects the magnitude of microcirculatory disturbance and tissue injury caused by ischemia/reperfusion. Therefore, continuous monitoring of not only PtO2 but also PtCO2 is beneficial for patients undergoing hepatic surgery with ischemia.
Urakami
A
A
Second Department of Surgery, Okayama University Medical School, Japan.
Hirai
R
R
Ota
T
T
Soga
H
H
Nawa
S
S
Shimizu
N
N
D000818:Animals; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000378:metabolism*; D004285:Dogs; D008099:Liver / Q000378:metabolism*; D008102:Liver Circulation; D013058:Mass Spectrometry; D008833:Microcirculation; D010100:Oxygen / Q000378:metabolism*; D010313:Partial Pressure; D015427:Reperfusion Injury / Q000503:physiopathology*
D002245:Carbon Dioxide; D010100:Oxygen