TY - JOUR
T1 - Progressive reduction in central blood volume is not detected by sublingual capnography
AU - Chung, Kevin K.
AU - Ryan, Kathy L.
AU - Rickards, Caroline A.
AU - Hinojosa-Laborde, Carmen
AU - Pamplin, Jeremy C.
AU - Patel, Shimul S.
AU - Herold, Thomas S.
AU - Convertino, Victor A.
PY - 2012/6
Y1 - 2012/6
N2 - Early detection and management of shock are important in optimizing clinical outcomes. One regional marker, sublingual capnography (SLCO 2), is particularly appealing as redistribution of blood flow away from the sublingual mucosa can happen very early in the compensatory phase of hypovolemic shock. Our objective was to test the hypothesis that SLCO 2 would detect early hypovolemia in a human laboratory model of hemorrhage: progressive lower body negative pressure until onset of cardiovascular collapse. Eighteen healthy nonsmoking subjects (10 males, 8 females) with mean age of 28 (SD, 8) years, body weight of 72 (SD, 13) kg, and height of 172 (SD, 9) cm were recruited to participate, of whom 17 completed the experiment. Average time to presyncope was 1,579 ± 72 s (mean ± SE). At the time of cardiovascular collapse, lower body negative pressure altered (P < 0.001) systolic blood pressure (mean ± SE: 130 ± 3 vs. 98 ± 2 mm Hg), pulse pressure (mean ± SE: 58 ± 2 vs. 33 ± 2 mm Hg), and heart rate (mean ± SE: 63 ± 3 vs. 102 ± 6 beats/min) when compared with baseline, whereas SLCO 2 did not change (49.1 ± 1.0 vs. 48.6 ± 1.5 mm Hg, P = 0.624). In a model of progressive central hypovolemia in humans, we did not detect metabolic derangements in the sublingual mucosa as measured by SLCO 2.
AB - Early detection and management of shock are important in optimizing clinical outcomes. One regional marker, sublingual capnography (SLCO 2), is particularly appealing as redistribution of blood flow away from the sublingual mucosa can happen very early in the compensatory phase of hypovolemic shock. Our objective was to test the hypothesis that SLCO 2 would detect early hypovolemia in a human laboratory model of hemorrhage: progressive lower body negative pressure until onset of cardiovascular collapse. Eighteen healthy nonsmoking subjects (10 males, 8 females) with mean age of 28 (SD, 8) years, body weight of 72 (SD, 13) kg, and height of 172 (SD, 9) cm were recruited to participate, of whom 17 completed the experiment. Average time to presyncope was 1,579 ± 72 s (mean ± SE). At the time of cardiovascular collapse, lower body negative pressure altered (P < 0.001) systolic blood pressure (mean ± SE: 130 ± 3 vs. 98 ± 2 mm Hg), pulse pressure (mean ± SE: 58 ± 2 vs. 33 ± 2 mm Hg), and heart rate (mean ± SE: 63 ± 3 vs. 102 ± 6 beats/min) when compared with baseline, whereas SLCO 2 did not change (49.1 ± 1.0 vs. 48.6 ± 1.5 mm Hg, P = 0.624). In a model of progressive central hypovolemia in humans, we did not detect metabolic derangements in the sublingual mucosa as measured by SLCO 2.
KW - Shock
KW - hemodynamics
KW - hypovolemia
KW - monitoring
KW - near-infrared spectroscopy
UR - http://www.scopus.com/inward/record.url?scp=84861461815&partnerID=8YFLogxK
U2 - 10.1097/SHK.0b013e318252da82
DO - 10.1097/SHK.0b013e318252da82
M3 - Article
C2 - 22552018
AN - SCOPUS:84861461815
SN - 1073-2322
VL - 37
SP - 586
EP - 591
JO - Shock
JF - Shock
IS - 6
ER -