Diagnostic utility of sublingual PCO2 for detecting hemorrhage in penetrating trauma patients.
BACKGROUND
Hemorrhage results in early compromise of splanchnic circulation. Studies have shown that sublingual Pco2 (SLCO2) correlates with gut perfusion. We tested SLCO2's ability to detect hemorrhage. We compared SLCO2 with arterial base deficit (BD) and lactate (LAC).


METHODS
This was a prospective study of patients with penetrating torso trauma. SLCO2 was measured at triage. Blood loss was defined as none (group 1), minimal to moderate (<1,500 mL) (group 2), or severe (>/=1,500 mL) (group 3). Data were reported as mean (95% confidence interval) and compared by analysis of variance. Receiver operating characteristic curves compared diagnostic performance between SLCO2, BD, and LAC.


RESULTS
One hundred eight patients were enrolled. There was a significant difference (p < 0.001) in SLCO2 between all blood loss groups: group 1, 46.9 mm Hg (44.9-49.0 mm Hg); group 2, 53.5 mm Hg (50.8-56.2 mm Hg); and group 3, 66.0 mm Hg (53.1-78.9 mm Hg). There were no significant (p > 0.05) differences for receiver operating characteristic curves between SLCO2, BD, or LAC.


CONCLUSIONS
SLCO2 differentiated blood loss groups. SLCO2 may be useful in triage of penetrating trauma patients.
Department of Emergency Medicine, State University of New York Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York 11203, USA. bonny.baron@verizon.net
Bonny J
BJ
Baron
Richard
R
Sinert
Shahriar
S
Zehtabchi
Karen L
KL
Stavile
Thomas M
TM
Scalea
D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D001785:Blood Gas Monitoring, Transcutaneous / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D009060:Mouth Floor; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012771:Shock, Hemorrhagic / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D014950:Wounds, Penetrating / Q000150:complications* / Q000453:epidemiology
D002245:Carbon Dioxide; D019344:Lactic Acid