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Intensive Care Medicine

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01-10-2008 | Experimental

Hypercapnia induces a concentration-dependent increase in gastric mucosal oxygenation in dogs

Authors: Ingo Schwartges, Lothar A. Schwarte, Artur Fournell, Thomas W. L. Scheeren, Olaf Picker

Published in: Intensive Care Medicine | Issue 10/2008

Abstract

Objective

To clarify the effects of hypercapnia (increased PaCO₂) on gastric mucosal oxygenation during anaesthesia in dogs.

Design

Prospective, controlled animal study.

Setting

Experimental research laboratory of an university hospital.

Subjects

Six chronically instrumented dogs.

Interventions

Dogs were anaesthetized (sevoflurane 1.5 MAC), mechanically ventilated (etCO₂ = 35 mmHg) and randomly assigned to the following protocols: in a first series, ventilation was adjusted to increase etCO₂ to 45, 55, 65 and 70 mmHg. In a second series, animals were ventilated to achieve 70 mmHg of etCO₂, which was maintained for 120 min to test if effects are transient or prolonged and to achieve a similar time course in both protocols.

Measurements and main results

Gastric mucosal oxygenation (μHbO₂) was assessed continuously by tissue reflectance spectrophotometry. Mean arterial blood pressure (MAP) and cardiac output (CO) were continuously measured. Blood was sampled for blood gas analysis and lactate concentration. Hypercapnia increased gastric mucosal oxygenation concentration dependently from 48 ± 6% (35 mmHg etCO₂) to 51 ± 4, 54 ± 5, 56 ± 5 and 59 ± 3% (etCO₂ 45, 55, 65 and 70 mmHg, respectively). This reflected changes in CO (68 ± 16, 74 ± 16, 82 ± 12, 91 ± 11 and 97 ± 16 ml kg⁻¹ min⁻¹, respectively) and systemic oxygen delivery (10 ± 2, 11 ± 3, 13 ± 2, 14 ± 2 and 14 ± 2 ml kg⁻¹ min⁻¹, respectively). These effects persisted for 2 h (μHbO₂ 53 ± 6 vs. 64 ± 4%, CO 73 ± 16 vs. 92 ± 15 ml kg⁻¹ min⁻¹, DO₂ 12 ± 4 vs. 14 ± 3 ml kg⁻¹ min⁻¹, etCO₂ 35 and 70 mmHg, respectively).

Conclusions

Hypercapnia increased systemic and regional oxygenation. If this experimental finding may be transferred to the clinical setting, permissive hypercapnia might be used to augment the oxygenation of the splanchnic region, e.g. gastrointestinal mucosa.

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Title: Hypercapnia induces a concentration-dependent increase in gastric mucosal oxygenation in dogs
Authors: Ingo Schwartges
Lothar A. Schwarte
Artur Fournell
Thomas W. L. Scheeren
Olaf Picker
Publication date: 01-10-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 10/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1183-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hypercapnia induces a concentration-dependent increase in gastric mucosal oxygenation in dogs

Abstract

Objective

Design

Setting

Subjects

Interventions

Measurements and main results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Subjects

Interventions

Measurements and main results

Conclusions

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