A novel approach to monitor tissue perfusion: Bladder mucosal Pco2, Po2, and pHi during ischemia and reperfusion

John D. Lang, David J. Evans, Luiz Poli DeFigueiredo, Steve Hays, Mali Mathru, George Kramer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: The purpose of this study is to determine if monitoring urinary bladder Pco2, Po2 and calculated intramucosal pH would be a reliable index of tissue perfusion. Materials and Methods: This nonrandomized controlled study was conducted in a laboratory at a university medical center. Eight immature female Yorkshire pigs were studied with T-9 aortic cross-clamping for 30 minutes followed by a 60-minute period of reperfusion. Cystotomy was performed for placement of a Foley catheter and Paratrend 7 o2/co2 sensor. Results: Baseline hemodynamic and metabolic measurements were obtained along with measurements of bladder mucosal Po2 and Pco2 (mean ± SEM). Blood flow measured with microspheres confirmed absence of blood flow during occlusion and hyperemia during reperfusion. Bladder mucosal Po2, decreased from 42 ± 14.0 mmHg (5.6 kPa) to 1.3 ± 1.3 mmHg (1.4 kPa) during the 30-minute interval of ischemia. This was followed by an increase of bladder Po2 to greater than baseline values at the end of the reperfusion period. Bladder mucosal Pco2 increased from 57 ± 4.7 mmHg (7.6 kPa) to 117 ± 7.1 mmHg (15.6 kPa) (P < .05) during ischemia. During reperfusion the Pco2 returned to baseline levels (55 ± 4.0 mmHg [7.3 kPa]). Calculated bladder mucosal pHi declined from 7.31 ± 0.04 to 7.08 ± 0.05 (P < .05) during the ischemic period and after reperfusion pHi was 7.17 ± 0.03. Conclusions: Monitoring urinary bladder Po2, Pco2, or calculating pHi may provide a simple and reliable means of monitoring tissue perfusion.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalJournal of Critical Care
Volume14
Issue number2
DOIs
StatePublished - Jun 1999
Externally publishedYes

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Reperfusion
Urinary Bladder
Ischemia
Perfusion
Cystotomy
Hyperemia
Microspheres
Constriction
Swine
Catheters
Hemodynamics

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

A novel approach to monitor tissue perfusion : Bladder mucosal Pco2, Po2, and pHi during ischemia and reperfusion. / Lang, John D.; Evans, David J.; DeFigueiredo, Luiz Poli; Hays, Steve; Mathru, Mali; Kramer, George.

In: Journal of Critical Care, Vol. 14, No. 2, 06.1999, p. 93-98.

Research output: Contribution to journalArticle

Lang, John D. ; Evans, David J. ; DeFigueiredo, Luiz Poli ; Hays, Steve ; Mathru, Mali ; Kramer, George. / A novel approach to monitor tissue perfusion : Bladder mucosal Pco2, Po2, and pHi during ischemia and reperfusion. In: Journal of Critical Care. 1999 ; Vol. 14, No. 2. pp. 93-98.
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N2 - Purpose: The purpose of this study is to determine if monitoring urinary bladder Pco2, Po2 and calculated intramucosal pH would be a reliable index of tissue perfusion. Materials and Methods: This nonrandomized controlled study was conducted in a laboratory at a university medical center. Eight immature female Yorkshire pigs were studied with T-9 aortic cross-clamping for 30 minutes followed by a 60-minute period of reperfusion. Cystotomy was performed for placement of a Foley catheter and Paratrend 7 o2/co2 sensor. Results: Baseline hemodynamic and metabolic measurements were obtained along with measurements of bladder mucosal Po2 and Pco2 (mean ± SEM). Blood flow measured with microspheres confirmed absence of blood flow during occlusion and hyperemia during reperfusion. Bladder mucosal Po2, decreased from 42 ± 14.0 mmHg (5.6 kPa) to 1.3 ± 1.3 mmHg (1.4 kPa) during the 30-minute interval of ischemia. This was followed by an increase of bladder Po2 to greater than baseline values at the end of the reperfusion period. Bladder mucosal Pco2 increased from 57 ± 4.7 mmHg (7.6 kPa) to 117 ± 7.1 mmHg (15.6 kPa) (P < .05) during ischemia. During reperfusion the Pco2 returned to baseline levels (55 ± 4.0 mmHg [7.3 kPa]). Calculated bladder mucosal pHi declined from 7.31 ± 0.04 to 7.08 ± 0.05 (P < .05) during the ischemic period and after reperfusion pHi was 7.17 ± 0.03. Conclusions: Monitoring urinary bladder Po2, Pco2, or calculating pHi may provide a simple and reliable means of monitoring tissue perfusion.

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