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J Appl Physiol 85: 2360-2364, 1998;
8750-7587/98 $5.00
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Vol. 85, Issue 6, 2360-2364, December 1998

Decreases in organ blood flows associated with increases in sublingual PCO2 during hemorrhagic shock

Xiaohua Jin1, Max Harry Weil1,2, Shijie Sun1,2, Wanchun Tang1,2, Joe Bisera1,2, and Earl J. Mason1

1 Institute of Critical Care Medicine, Palm Springs 92262; and 2 The University of Southern California School of Medicine, Los Angeles, California 90033

Earlier studies demonstrated that not only the stomach but also the esophageal wall served as an appropriate site for estimating the severity of circulatory shock by using tonometric methods. We then conceived of the option of sublingual tonometry. In the present study, we tested the hypothesis that the changes in sublingual PCO2 serve as indicators of decreases in blood flow to sublingual and visceral tissue. In Sprague-Dawley rats, sublingual PCO2 increased from 50 to 127 Torr and arterial blood lactate increased from 0.9 to 11.2 mmol/l during bleeding. Sublingual blood flow simultaneously decreased to ~32% of preshock values. After reinfusion of shed blood, organ blood flows and sublingual PCO2 were promptly restored to near-baseline values. There were corresponding decreases in blood flows in the tongue, stomach, jejunum, colon, and kidneys during hemorrhagic shock. Increases in sublingual PCO2 were highly correlated with decreases in sublingual blood flow (r = 0.80), tongue blood flow (r = 0.81), gastric blood flow (r = 0.74), jejunal blood flow (r = 0.65), colon blood flow (r = 0.80), and renal blood flow (r = 0.75). Unbled control animals demonstrated no significant changes. Therefore, we anticipate that sublingual tonometry will provide a useful, noninvasive alternative for monitoring visceral PCO2.

sublingual carbon dioxide pressure; regional blood flow; rat; tissue hypercarbia


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