Shime N, Yoshioka M, Fukui M, Hatanaka T, Yan T, Tanaka Y
Department of Anesthesiology, Kyoto Prefectural University of Medicine.
Masui. 1994 Aug;43(8):1174-8.
We measured transcutaneous gas tensions of both anterior thorax and femur. The differences between the two transcutaneous gas tensions were compared, as well as the relationship between the two transcutaneous and mixed venous blood gas tensions, in 10 dogs during hemorrhagic shock. The changes in femoral transcutaneous gas tensions correlated better with the changes in mixed venous gas tensions. The correlation between the two transcutaneous gas tensions were fairly good (oxygen tensions; r = .827, carbon dioxide tensions; r = .867). However, the discrepancy between the two gas tensions became greater in severe shock. Hence, oxygen tensions became smaller and carbon dioxide tensions became greater on femur than on anterior thorax. This indicates the possibility of "maldistribution of blood flow", which has already been detected between vital organs and skin, also exists between peripheral and central skin. Therefore, transcutaneous gas tensions should be monitored at peripheral skin, where gas tensions show greater changes and reflect systemic perfusion precisely than at central skin, during shock.
我们测量了前胸和股骨的经皮气体张力。在10只狗失血性休克期间，比较了两种经皮气体张力之间的差异，以及两种经皮气体张力与混合静脉血气张力之间的关系。股骨经皮气体张力的变化与混合静脉气体张力的变化相关性更好。两种经皮气体张力之间的相关性相当好（氧张力；r = 0.827，二氧化碳张力；r = 0.867）。然而，在严重休克时，两种气体张力之间的差异变得更大。因此，股骨上的氧张力比前胸上的小，二氧化碳张力比前胸上的大。这表明在重要器官和皮肤之间已检测到的“血流分布不均”的可能性在外周皮肤和中央皮肤之间也存在。因此，在休克期间，应监测外周皮肤的经皮气体张力，在外周皮肤处气体张力变化更大，比中央皮肤更能准确反映全身灌注情况。
