Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-19T11:07:11.195Z Has data issue: false hasContentIssue false
  • English
  • Français

A new simple tool for tonometric determination of the PCO2 in the gastrointestinal tract: in vitro and in vivo validation studies

Published online by Cambridge University Press:  04 April 2006

D. Boda ,
J. Kaszaki  and
G. Tálosi
D. Boda
Affiliation:
University of Szeged, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Department of Paediatrics, Hungary
J. Kaszaki
Affiliation:
University of Szeged, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Department of Surgical Research, Hungary
G. Tálosi
Affiliation:
University of Szeged, Albert Szent-Györgyi Medical and Pharmaceutical Centre, Department of Paediatrics, Hungary
Get access

Extract

Summary

Background and objective: Following the discovery of the feasibility of assessing the adequacy of the splanchnic perfusion by means of gastrotonometry, this technique became extensively used in clinical practice and in research. At present, high-technology instruments are available for the purpose. However, there is still a need for a simple, cheap tool that is easily applicable for patients of all ages. The present article describes such a tool and presents the results of in vitro and in vivo validation measurements with it. Methods: Balloon-free tonometric probes consisting of silicone rubber tubes were developed. In vitro measurements of the uptake of CO2 inside the probes and for comparison in a conventional ballooned intestinal tonometer were made in a closed container maintained at 37°C. In in vivo studies in anaesthetized dogs, the tonometric PCO2 values were determined with a tonometric probe and catheter introduced simultaneously into the ileum of the animals and the results were analysed by the Bland–Altman method. Results: The in vitro equilibration studies revealed that the filling media inside the probes equilibrated rapidly with the PCO2 content of the chamber. The data obtained from the in vivo investigations with the two different methods demonstrated a statistically significant linear association (correlation coefficient: 0.778, significance: P < 0.001). Conclusion: The new simple tonometric probe described appears to be a reliable tool with certain advantages for gastric tonometry. However, further studies are warranted before its general clinical use.

Keywords

METHODS, tonometryGASTROINTESTINAL TRACTVALIDATION STUDIES, in vitro, in vivo
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 8 , August 2006 , pp. 680 - 685
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Boda D, Murányi L. Gastrotonometry: an aid to the control of ventilation during artificial respiration. Lancet 1959; I: 181–182.Google Scholar
Fiddian-Green RG, Baker S. Predictive value of the stomach wall pH for complications after cardiac operations: comparison with other monitoring. Crit Care Med 1987; 15: 153–156.Google Scholar
Chapman MV, Mythen MG, Webb AR, Vincent JL. Report from the meeting: Gastrointestinal Tonometry: State of the Art. 22nd–23rd May 1998, London, UK. Intensive Care Med 2000; 26: 613–622.Google Scholar
Knuesel R, Jakob SM, Brander L, Bracht H, Siegenthaler A, Takala J. Changes in regional blood flow and PCO2 gradients during isolated abdominal aortic blood flow reduction. Intensive Care Med 2003; 29: 2255–2265.Google Scholar
Levy B, Gawalkiewicz P, Vallet B, Briancon S, Nace L, Bollaert PE. Gastric capnometry with air-automated tonometry predicts outcome in critically ill patients. Crit Care Med 2003; 31: 474–480.Google Scholar
Gutierrez G, Palizas F, Doglio G et al. Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 1992; 339: 195–199.Google Scholar
Masai T, Taniguchi K, Kuki S et al. Usefulness of continuous air tonometry for evaluation of splanchnic perfusion during cardiopulmonary bypass. ASAIO J 2003; 49: 108–111.Google Scholar
Marik PE. Sublingual capnography: a clinical validation study. Chest 2001; 120: 923–927.Google Scholar
Heinonen PO, Jousela IT, Blomqvist KA, Olkkola KT, Takkunen OS. Validation of air tonometric measurement of gastric regional concentrations of CO2 in critically ill septic patients. Intensive Care Med 1997; 23: 524–529.Google Scholar
Rackow EC, O’Neil P, Astiz ME, Carpati CM. Sublingual capnometry and indexes of tissue perfusion in patients with circulatory failure. Chest 2001; 120: 1633–1638.Google Scholar
Venkatesh B, Morgan TJ, Lipman J. Subcutaneous oxygen tensions provide similar informations to ileal luminal CO2 tensions in an animal model of hemorrhagic shock. Intensive Care Med 2000; 26: 592–600.Google Scholar
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; I: 307–310.Google Scholar
Creteur J, De Backer D, Vincent JL. Monitoring gastric mucosal carbon dioxide pressure using gas tonometry:in vitro and in vivo validation studies. Anesthesiology 1997; 87: 504–510.Google Scholar
Temmesfeld-Wollbruck B, Szalay A, Olschewski H, Grimminger F, Seeger W. Advantage of buffered solutions or automated capnometry in air-filled balloons for use in gastric tonometry. Intensive Care Med 1997; 23: 423–427.Google Scholar
Kolkman JJ, Zwarekant LJ, Boshuizen K, Groeneveld ABJ, Steverink PLGM, Meuwissen SGM. Type of solution and PCO2 measurement errors during tonometry. Intensive Care Med 1997; 23: 658–663.Google Scholar
Sato Y, Weil MH, Tang W et al. Esophageal PCO2 as a monitor of perfusion failure during hemorrhagic shock. J Appl Physiol 1997; 82: 558–562.Google Scholar