Journal of Applied Physiology
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J Appl Physiol 82: 558-562, 1997;
8750-7587/97 $5.00
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Journal of Applied Physiology
Vol. 82, No. 2, pp. 558-562, February 1997
SYSTEMIC CIRCULATION AND FLUID BALANCE

Esophageal PCO2 as a monitor of perfusion failure during hemorrhagic shock

Yoji Sato1, Max Harry Weil1,2, Wanchun Tang1,2, Shijie Sun1,2, Jianlin Xie1, Joe Bisera1,2, and Hidehiro Hosaka3

1 The Institute of Critical Care Medicine, Palm Springs 92262-5309; 2 The University of Southern California School of Medicine, Los Angeles, California 90033-1039; and 3 Nihon Kohden Corporation, Tokyo 161, Japan

Received 25 March 1996; accepted in final form 5 September 1996.

Sato, Yoji, Max Harry Weil, Wanchun Tang, Shijie Sun, Jianlin Xie, Joe Bisera, and Hidehiro Hosaka. Esophageal PCO2 as a monitor of perfusion failure during hemorrhagic shock. J. Appl. Physiol. 82(2): 558-562, 1997.---Measurement of gastric wall PCO2 (PgCO2) by tonometric method has emerged as an attractive option for estimating visceral perfusion during circulatory shock. However, gastric acid secretion obfuscates the tonometric measurement. We, therefore, investigated the option of measuring PCO2 in the esophagus to minimize these restraints. Hemorrhagic shock was induced in five Sprague-Dawley rats, and five rats served as sham controls. PgCO2 was measured with an ion-sensitive field effect transistor that was surgically implanted into the gastric wall. Esophageal luminal PCO2 (PeCO2) was measured by a second ion-sensitive field effect transistor sensor. During hemorrhagic shock, mean aortic pressure declined from 150 to 50 mmHg. Gastric blood flow decreased from 58 to 12 ml · min-1 · 100 g-1 (21% of preshock) and esophageal blood flow from 44 to 7 ml · min-1 · 100 g-1 (16% of preshock). PgCO2 simultaneously increased from 47 to 116 Torr and PeCO2 from 47 to 127 Torr. The increases in PgCO2 were highly correlated with increases in PeCO2 (r = 0.90). Esophageal tonometry may, therefore, serve as a practical alternative to gastric tonometry.

gastric partial pressure of carbon dioxide; esophageal partial pressure of carbon dioxide; gastric tonometry; rat

0161-7567/97 $5.00 Copyright © 1997 the American Physiological Society




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