Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement
Introduction: Given the redistribution of blood flow away from non-immediately vital territories during hemorrhagic shock, we investigate whether monitoring the oral mucosal PCO2 (POMCO2) as a surrogate of splanchnic circulation, could closely recognize the onset, assess severity, and identify rever...
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Elsevier
2024-12-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424002650 |
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| author | Armin Razi Iyad M. Ayoub Alvin Baetiong Salvatore Aiello Moaz Bin Saeed Martin Pelletier Cara Joyce Raúl J. Gazmuri |
| author_facet | Armin Razi Iyad M. Ayoub Alvin Baetiong Salvatore Aiello Moaz Bin Saeed Martin Pelletier Cara Joyce Raúl J. Gazmuri |
| author_sort | Armin Razi |
| collection | DOAJ |
| description | Introduction: Given the redistribution of blood flow away from non-immediately vital territories during hemorrhagic shock, we investigate whether monitoring the oral mucosal PCO2 (POMCO2) as a surrogate of splanchnic circulation, could closely recognize the onset, assess severity, and identify reversal of hemorrhagic shock. Material and methods: The study was performed on six male pigs (38.4 ± 1.6 kg). POMCO2 was measured using a non-invasive sensor clipped to the cheek. Blood was removed over 120 min from the right atrium modeling spontaneous bleeding and reinfused in 20 min observing the animal for 180 min. Results: A total of 1485 ± 188 ml (i.e., 64.6 ± 9.5 % of the estimated blood volume) was removed inducing severe hemorrhagic shock. POMCO2 closely paralleled the blood volume change (R2 = 0.59, p < 0.001) showing an early and steady increase from 86 ± 5 mmHg at baseline to 152 ± 28 mmHg after 120 min. Blood reinfusion reduced the POMCO2 to 138 ± 37 mmHg after 15 min and 97 ± 34 mmHg at the end of 180 min, coincident with the reversal of hemorrhagic shock. Blood lactate less accurately paralleled the blood volume change (R2 = 0.14, p < 0.001) showing a slower increase during hemorrhagic shock (from 1.1 ± 0.3 to 4.2 ± 1.8 mmol/l after 120 min) with further increase to 5.2 ± 1.7 mmol/l following blood reinfusion at minute 150 min, remaining at 4.0 ± 1.5 mmol/l by the end of the 180-minute observation period. Conclusions: POMCO2 monitoring may provide a clinically practical non-invasive indicator of hemorrhagic shock assessing its severity, clinical course, and treatment effect outperforming blood lactate which exhibited a slower and delayed response. |
| format | Article |
| id | doaj-art-b75f0a1d32e24cdcb9da96cab38b9b9e |
| institution | DOAJ |
| issn | 2666-5204 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-b75f0a1d32e24cdcb9da96cab38b9b9e2025-08-20T02:40:08ZengElsevierResuscitation Plus2666-52042024-12-012010081410.1016/j.resplu.2024.100814Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurementArmin Razi0Iyad M. Ayoub1Alvin Baetiong2Salvatore Aiello3Moaz Bin Saeed4Martin Pelletier5Cara Joyce6Raúl J. Gazmuri7Resuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USAResuscitation Therapeutics, North Chicago, IL, USAResuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USAResuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USAResuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USAResuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USALoyola University Chicago Health Sciences Campus, Maywood, IL, USAResuscitation Institute at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA; Critical Care Section at the CAPT James A. Lovell Federal Health Care Center, North Chicago, IL, USA; Resuscitation Therapeutics, North Chicago, IL, USA; Corresponding author at: Resuscitation Institute, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL 60064, USA.Introduction: Given the redistribution of blood flow away from non-immediately vital territories during hemorrhagic shock, we investigate whether monitoring the oral mucosal PCO2 (POMCO2) as a surrogate of splanchnic circulation, could closely recognize the onset, assess severity, and identify reversal of hemorrhagic shock. Material and methods: The study was performed on six male pigs (38.4 ± 1.6 kg). POMCO2 was measured using a non-invasive sensor clipped to the cheek. Blood was removed over 120 min from the right atrium modeling spontaneous bleeding and reinfused in 20 min observing the animal for 180 min. Results: A total of 1485 ± 188 ml (i.e., 64.6 ± 9.5 % of the estimated blood volume) was removed inducing severe hemorrhagic shock. POMCO2 closely paralleled the blood volume change (R2 = 0.59, p < 0.001) showing an early and steady increase from 86 ± 5 mmHg at baseline to 152 ± 28 mmHg after 120 min. Blood reinfusion reduced the POMCO2 to 138 ± 37 mmHg after 15 min and 97 ± 34 mmHg at the end of 180 min, coincident with the reversal of hemorrhagic shock. Blood lactate less accurately paralleled the blood volume change (R2 = 0.14, p < 0.001) showing a slower increase during hemorrhagic shock (from 1.1 ± 0.3 to 4.2 ± 1.8 mmol/l after 120 min) with further increase to 5.2 ± 1.7 mmol/l following blood reinfusion at minute 150 min, remaining at 4.0 ± 1.5 mmol/l by the end of the 180-minute observation period. Conclusions: POMCO2 monitoring may provide a clinically practical non-invasive indicator of hemorrhagic shock assessing its severity, clinical course, and treatment effect outperforming blood lactate which exhibited a slower and delayed response.http://www.sciencedirect.com/science/article/pii/S2666520424002650Hemorrhagic shockCapnometrySwinePOMCO2Lactate |
| spellingShingle | Armin Razi Iyad M. Ayoub Alvin Baetiong Salvatore Aiello Moaz Bin Saeed Martin Pelletier Cara Joyce Raúl J. Gazmuri Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement Resuscitation Plus Hemorrhagic shock Capnometry Swine POMCO2 Lactate |
| title | Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement |
| title_full | Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement |
| title_fullStr | Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement |
| title_full_unstemmed | Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement |
| title_short | Oral-Mucosal PCO2 during hemorrhagic shock closely Monitors its time Course, Severity, and reversal outperforming blood lactate measurement |
| title_sort | oral mucosal pco2 during hemorrhagic shock closely monitors its time course severity and reversal outperforming blood lactate measurement |
| topic | Hemorrhagic shock Capnometry Swine POMCO2 Lactate |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424002650 |
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