Accession Number : ADA615171


Title :   Progressive Reduction in Central Blood Volume is not Detected by Sublingual Capnography


Descriptive Note : Journal article


Corporate Author : ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX


Personal Author(s) : Chung, CKevin K ; Ryan, Kathy L ; Rickards, Caroline A ; Hinojosa-Laborde, Carmen ; Pamplin, Jeremy C ; Patel, Shimul S ; Herold, Thomas S ; Convertino, Victor A


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a615171.pdf


Report Date : Jan 2012


Pagination or Media Count : 7


Abstract : Early detection and management of shock are important in optimizing clinical outcomes. One regional marker, sublingual capnography (SLCO2), 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 SLCO2 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 SLCO2 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 SLCO2.


Descriptors :   *BLOOD VOLUME , INFRARED SPECTROSCOPY , MONITORING , NEAR INFRARED RADIATION , SHOCK


Subject Categories : Anatomy and Physiology
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE