Authors: IF Tugtekin P Radermacher M Theisen M Matejovic A Stehr F Ploner K Matura C Ince M Georgieff K Träger
Publish Date: 2001/03/02
Volume: 27, Issue: 4, Pages: 757-766
Abstract
Objective To investigate whether an increased ilealmucosalarterial PCO2 gap ΔPCO2 during hyperdynamic porcine endotoxemia is associated with impaired villus microcirculation Design Prospective randomized controlled experimental study Setting Animal research laboratory Animals Twentytwo domestic pigs Interventions After baseline measurements anesthetized and ventilated pigs received continuous iv endotoxin ETX n=12 for 24 h or placebo SHAM n=10 Measurements and results Before as well as 12 and 24 h after the start of endotoxin or saline portal venous blood flow QPV ultrasound flow probe and lactate/pyruvate ratios L/P the ilealmucosalarterial ΔPCO2 fiberoptic sensor and bowelwall capillary hemoglobin O2 saturation HbO2cap remission spectrophotometry were assessed together with intravital video records of the ilealmucosal microcirculation number of perfused/heterogeneously perfused/unperfused villi using orthogonal polarization spectral imaging CYTOSCAN A/R via an ileostomy At 12 and 24 h endotoxin infusion about half of the evaluated villi were heterogeneously or unperfused which was paralleled by a progressive significant increase of the ilealmucosalarterial ΔPCO2 and portal venous L/P ratios whereas QPV as well as both the mean HbO2cap and the HbO2cap frequency distributions remained unchanged By contrast in the SHAMgroup mucosal microcirculation was wellpreserved and none of the other parameters were influenced Conclusions We conclude that an increased ilealmucosalarterial ΔPCO2 during porcine endotoxemia is related to impaired villus microcirculation A putative contribution of disturbed cellular oxygen utilization resulting from cytopathic hypoxia may also assume importance
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