Jin X, Weil M H, Sun S, Tang W, Bisera J, Mason E J
Institute of Critical Care Medicine, Palm Springs, CA 92262, USA.
J Appl Physiol (1985). 1998 Dec;85(6):2360-4. doi: 10.1152/jappl.1998.85.6.2360.
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 approximately 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.
早期研究表明，不仅胃，食管壁也可作为通过张力测定法评估循环性休克严重程度的合适部位。然后我们想到了舌下张力测定法。在本研究中，我们检验了以下假设：舌下PCO2的变化可作为舌下和内脏组织血流减少的指标。在斯普拉格-道利大鼠中，出血期间舌下PCO2从50 Torr升至127 Torr，动脉血乳酸从0.9 mmol/l升至11.2 mmol/l。舌下血流同时降至休克前值的约32%。回输失血后，器官血流和舌下PCO2迅速恢复至接近基线值。失血性休克期间，舌、胃、空肠、结肠和肾脏的血流相应减少。舌下PCO2的升高与舌下血流减少（r = 0.80）、舌血流减少（r = 0.81）、胃血流减少（r = 0.74）、空肠血流减少（r = 0.65）、结肠血流减少（r = 0.80）和肾血流减少（r = 0.75）高度相关。未出血的对照动物未显示出显著变化。因此，我们预期舌下张力测定法将为监测内脏PCO2提供一种有用的非侵入性替代方法。
