Sublingual capnometry: an alternative to gastric tonometry for the management of shock resuscitation.
Normal vital signs do not reflect the physiologic aberrations after blood loss. Recognition of hypoperfusion during resuscitation can avoid the development of multiple organ failure. Advances in technology enable the clinician to monitor changes, potentially identifying tissue hypoxia much earlier than previously was possible. Gastric tonometry can be quite helpful in the intensive care unit in identifying gastric hypoperfusion, but has considerable drawbacks. The ability to monitor P(SI)CO(2) via sublingual capnometers overcomes some limitations of gastric tonometry and may be a valuable aid in the prehospital phase, the emergency department, and the intensive care unit in identifying end points of resuscitation.
Boswell
Sharon A
SA
R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Md, USA. sboswell@umm.edu
Scalea
Thomas M
TM
D001810:Blood Volume; D019296:Capnography / Q000379:methods* / Q000451:nursing / Q000639:trends; D003422:Critical Care / Q000379:methods; D005544:Forecasting; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008991:Monitoring, Physiologic / Q000379:methods* / Q000451:nursing; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control; D010101:Oxygen Consumption; D012151:Resuscitation / Q000379:methods* / Q000451:nursing; D012769:Shock / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy*; D013270:Stomach / Q000098:blood supply; D013997:Time Factors; D014059:Tongue / Q000098:blood supply*
D019344:Lactic Acid