Occlusive mesenteric ischemia and its effects on jejunal intramucosal pH, mesenteric oxygen consumption and oxygen tensions from surfaces of the jejunum in anesthetized pigs

• Published in: Intensive care medicine 1997-01, Vol.23 (1), p.91-99
• Main Authors: PARGGER, H, STAENDER, S, STUDER, W, SCHELLSCHEIDT, O, MIHATSCH, M. J, SCHEIDEGGER, D, SKARVAN, K
• Format: Article
• Language: English
• Subjects: Acidosis; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Carbon dioxide; Catheters; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Hemodynamics; Hemoglobin; Hogs; Hydrogen-Ion Concentration; Intensive care medicine; Intestines - blood supply; Ischemia; Ischemia - etiology; Ischemia - metabolism; Ischemia - pathology; Jejunum - metabolism; Jejunum - pathology; Ketamine; Laboratories; Laparotomy; Linear Models; Manometry; Medical sciences; Mesenteric Artery, Superior; Mesenteric Vascular Occlusion - complications; Mesenteric Vascular Occlusion - metabolism; Mesenteric Vascular Occlusion - physiopathology; Metabolism; Ostomy; Oxygen Consumption; Prospective Studies; Pulmonary arteries; Random Allocation; Sepsis; Small intestine; Statistics, Nonparametric; Swine; Veins & arteries; Ventilators
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s001340050296

To investigate the effects of superior mesenteric artery (SMA) flow reduction on the jejunal intramucosal pH (pHi) and to compare these effects with corresponding changes of mesenteric oxygen transport variables and oxygen tensions on the surfaces of the jejunal serosa and mucosa. Prospective, randomized, controlled, experimental study. Animal research laboratory. 20 domestic pigs. Mechanical flow reduction in the SMA. The animals were randomized to have an SMA flow of 0%, 25%, 38%, 50% or 100% (control). Measurements (baseline, ischemia, reperfusion) consisted of hemodynamic and oxygen transport variables, SMA blood flow, mesenteric oxygen transport variables, pHi and oxygen tensions of the jejunal serosa and mucosa. Flow reduction in the SMA resulted in a significant decrease of pHi indicating ischemia earlier than mesenteric oxygen transport variables. The relationship between mesenteric oxygen delivery (DO2ms) and pHi during acute ischemia is best described by a sigmoid curve. There was a linear correlation between the changes of the jejunal surface oxygen tensions and pHi due to SMA flow reduction. The sigmoid relationship between pHi and DO2ms indicated that pHi is a sensitive parameter for detecting ischemia at 50% of the baseline oxygen delivery and that below 25% there was no further decrease of pHi. In contrast, mesenteric and whole body oxygen transport parameters were not indicative of impaired mucosal oxygen supply.