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


CONCLUSIONS
Direct measurement of tissue oxygen saturation with a prototype side-illuminating near-infrared spectroscopy gastric probe appeared to rapidly reflect changes in splanchnic perfusion.
Cohn
S M
SM
Department of Surgery, University of Miami School of Medicine, Miami, Florida 33101, USA. stephen.cohn@miami.edu
Varela
J E
JE
Giannotti
G
G
Dolich
M O
MO
Brown
M
M
Feinstein
A
A
McKenney
M G
MG
Spalding
P
P
D000704:Analysis of Variance; D000818:Animals; D001783:Blood Flow Velocity; D001784:Blood Gas Analysis; D001794:Blood Pressure; D004195:Disease Models, Animal; D005753:Gastric Mucosa / Q000098:blood supply* / Q000737:chemistry* / Q000378:metabolism; D007441:Intubation, Gastrointestinal; D007552:Isotonic Solutions; D007582:Jejunostomy; D007583:Jejunum / Q000098:blood supply / Q000737:chemistry / Q000378:metabolism; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010100:Oxygen / Q000032:analysis*; D010101:Oxygen Consumption; D012151:Resuscitation / Q000379:methods; D000077325:Ringer's Lactate; D012771:Shock, Hemorrhagic / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D013152:Splanchnic Circulation; D013552:Swine; D013997:Time Factors
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D010100:Oxygen