RESUMEN
The transcutaneous assessment of tissue oxygenation has become a useful method for evaluating microcirculatory disorders in different diseases. In this clinical experimental pilot study, the impact of compound fractures on tissue oxygenation was examined. Using a special probe placed directly into the muscle, tissue oxygenation was measured at the site of tissue injury as well as at one non-injured site within the same fractured extremity. A non-injured extremity was also measured as a control. At the injured site tissue oxygenation was significantly increased during the first 4 days after trauma compared with the non-injured extremity (40.7 +/- 1.8 mmHg versus 23.5 +/- 4.1 mmHg). At the same time the non-injured site of the fractured extremity appeared to be significantly less oxygenated compared with the non-injured extremity (13.2 +/- 2.3 mmHg versus 23.5 +/- 4.1 mmHg). After day 4 until the end of the study (day 10) a complete return to normal values was noted at both sites. In conclusion, it is most likely that, due to a change of microcirculation within the fractured extremity, the injured site is temporarily oversaturated by oxygen and this is associated with low oxygenation at the non-injured site on the same extremity. As the microcirculatory status may be important in making decisions about trauma surgery (e.g. whether or not to amputate), transcutaneous oxygen measurement is a practical and useful method in trauma care.
Asunto(s)
Fracturas Abiertas/sangre , Pierna/irrigación sanguínea , Oxígeno/sangre , Fracturas de la Tibia/sangre , Adolescente , Adulto , Monitoreo de Gas Sanguíneo Transcutáneo/instrumentación , Monitoreo de Gas Sanguíneo Transcutáneo/métodos , Femenino , Fijación Interna de Fracturas , Fracturas Abiertas/diagnóstico , Fracturas Abiertas/cirugía , Humanos , Puntaje de Gravedad del Traumatismo , Unidades de Cuidados Intensivos , Masculino , Microcirculación , Persona de Mediana Edad , Músculo Esquelético/metabolismo , Consumo de Oxígeno/fisiología , Proyectos Piloto , Estadísticas no Paramétricas , Fracturas de la Tibia/diagnóstico , Fracturas de la Tibia/cirugía , Cicatrización de Heridas/fisiologíaRESUMEN
The transcutaneous assessment of tissue oxygenation has become an useful method in evaluating microcirculatory disorders in different diseases. In this clinical experimental pilot study the impact of compound fractures on tissue oxygenation was examined. Using a special probe placed directly into the muscle, tissue oxygenation was measured at the site of tissue injury as well as at one non-injured site within the same fractured extremity. Furthermore, also one non-injured extremity was measured as a control. At the injured site tissue oxygenation was significantly increased during the first 4 days after trauma as compared to the non-injured extremity (40.7 +/- 1.8 mmHg vs. 23.5 +/- 4.1 mmHg). At the same time the non-injured site of the fractured extremity appeared to be significantly less oxygenated as compared to the noninjured extremity (13.2 +/- 2.3 mmHg vs. 23.5 +/- 4.1 mmHg). After day 4 until the end of the study (day 10) a complete return to normal values was noted at both sites. In conclusion it is most likely that due to a change of microcirculation within the fractured extremity the injured site is temporarily oversaturated by oxygen combined with lacking oxygenation at the non-injured site. As the microcirculatory status may be important in making decision in trauma surgery (e.g. whether or not to amputate) the method of transcutaneous oxygen measurement is a practical and useful method in trauma care.
Asunto(s)
Monitoreo de Gas Sanguíneo Transcutáneo/instrumentación , Fracturas Abiertas/fisiopatología , Traumatismos de los Tejidos Blandos/fisiopatología , Fracturas de la Tibia/fisiopatología , Adolescente , Adulto , Femenino , Fracturas Abiertas/cirugía , Humanos , Masculino , Microcirculación/fisiología , Persona de Mediana Edad , Músculo Esquelético/irrigación sanguínea , Músculo Esquelético/lesiones , Consumo de Oxígeno/fisiología , Proyectos Piloto , Traumatismos de los Tejidos Blandos/cirugía , Fracturas de la Tibia/cirugíaAsunto(s)
Hemodilución , Músculo Esquelético/metabolismo , Oxígeno/sangre , Oxígeno/metabolismo , Adulto , Anciano , Anestesia , Viscosidad Sanguínea/fisiología , Femenino , Hematócrito , Humanos , Hipoxia/sangre , Hipoxia/metabolismo , Masculino , Microcirculación/fisiología , Persona de Mediana EdadRESUMEN
In the anesthetized, open-chest rat, alterations of the respiratory minute volume were induced by changes of the respiratory frequency. Mean tissue pO2 of skeletal muscle in healthy and distressed rats did not change significantly. 10 minutes after a ventilation stop lasting 60 seconds, healthy rats showed an approximately normalized pO2 histogram, whereas distressed rats did not seem to recover. The results indicate an independent regulation mechanism which maintains a sufficient oxygen supply to skeletal tissue of anesthetized rats. The efficacy of this mechanism seemed to be reduced in distressed rats after the ventilation stop.
Asunto(s)
Músculos/metabolismo , Consumo de Oxígeno , Respiración/fisiología , Insuficiencia Respiratoria/fisiopatología , Animales , Presión Sanguínea , Frecuencia Cardíaca , Masculino , Presión Parcial , Ratas , Ratas Sprague-Dawley , Valores de Referencia , Insuficiencia Respiratoria/metabolismo , Resistencia VascularRESUMEN
Direct measurements of local oxygen pressure by means of platinum multiwire electrode were performed in rats to investigate the effect of an end-to-side portocaval shunt procedure on muscle tissue oxygenation. Compared with intact rats and/or sham operated animals, rats with portocaval anastomosis showed a significant increase of muscle tissue oxygenation with nearly bellshaped pO2 histograms. This considerable increase in tissue oxygenation might appear to be due to the well known PCA induced hyperdynamic cardiovascular state.