Supplemental oxygen, but not supplemental crystalloid fluid, increases tissue oxygen tension in healthy and anastomotic colon in pigs.
BACKGROUND
Low tissue oxygen tension is an important factor leading to the development of wound dehiscence and anastomotic leakage after colon surgery. We tested whether supplemental fluid and supplemental oxygen can increase tissue oxygen tension in healthy and injured, perianastomotic, and anastomotic colon in an acutely instrumented pig model of anastomosis surgery.


METHODS
Sixteen Swiss Landrace pigs were anesthetized (isoflurane 0.8%-1%) and their lungs ventilated. The animals were randomly assigned to low fluid treatment ("low" group, 3 mL x kg(-1) x h(-1) lactated Ringer's solution) or high fluid treatment ("high" group, 10 mL/kg bolus, 18 mL x kg(-1) x h(-1) lactated Ringer's solution) during colon anastomosis surgery and a subsequent measurement period (4 h). Two-and-half hours after surgery, tissue oxygen tension was recorded for 30 min during ventilation with 30% oxygen. Three hours after surgery, the animals' lungs were ventilated with 100% oxygen for 60 min. Tissue oxygen tension was recorded in the last 30 min. Tissue oxygen tension was measured with polarographic Clark-type electrodes, positioned in healthy colonic wall, close (2 cm) to the anastomosis, and in the anastomosis.


RESULTS
In every group, tissue oxygen tension during ventilation with 100% oxygen was approximately twice as high as during ventilation with 30% oxygen, a statistically significant result. High or low volume crystalloid fluid treatment had no effect on colon tissue oxygen tension.


CONCLUSIONS
Supplemental oxygen, but not supplemental crystalloid fluid, increased tissue oxygen tension in healthy, perianastomotic, and anastomotic colon tissue.
Kimberger
Oliver
O
Department of Anesthesiology, University of Bern, Switzerland. study@kimberger.at
Fleischmann
Edith
E
Brandt
Sebastian
S
Kugener
André
A
Kabon
Barbara
B
Hiltebrand
Luzius
L
Krejci
Vladimir
V
Kurz
Andrea
A
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D002302:Cardiac Output; D003106:Colon / Q000187:drug effects* / Q000378:metabolism / Q000601:surgery; D000077324:Crystalloid Solutions; D005440:Fluid Therapy / Q000379:methods*; D006339:Heart Rate; D006454:Hemoglobins / Q000378:metabolism; D007552:Isotonic Solutions / Q000494:pharmacology* / Q000627:therapeutic use; D023421:Models, Animal; D010100:Oxygen / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D010313:Partial Pressure; D011669:Pulmonary Wedge Pressure; D000077325:Ringer's Lactate; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D034421:Sus scrofa; D013997:Time Factors
D000077324:Crystalloid Solutions; D006454:Hemoglobins; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D002245:Carbon Dioxide; D010100:Oxygen