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British Journal of Anaesthesia, 2000, Vol. 85, No. 4 563-569
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Gastric mucosal end-tidal PCO2 difference as a continuous indicator of splanchnic perfusion

A. Uusaro*, P. Lahtinen, I. Parviainen and J. Takala1

Critical Care Research Program, Department of Anesthesiology and Intensive Care, Division of Critical Care, Kuopio University Hospital, Kuopio, Finland 1Present address: Department of Intensive Care Medicine, University Hospital of Bern (Inselspital), Bern, Switzerland

Gastric mucosal and arterial blood PCO2 must be known to assess mucosal perfusion by means of gastric tonometry. As end-tidal PCO2 (PE'CO2) is a function of arterial PCO2, the gradient between PE'CO2 and gastric mucosal PCO2 may reflect mucosal perfusion. We studied the agreement between two methods to monitor gut perfusion. We measured the difference between gastric mucosal PCO2 (air tonometry) and PE'CO2 (=DPCO2gas) and the difference between gastric mucosal PCO2 (saline tonometry) and arterial blood PCO2 (=DPCO2sal) in 20 patients with or without lung injury. DPCO2gas was greater than DPCO2sal but changes in DPCO2gas reflected changes in DPCO2sal. The bias between DPCO2gas and DPCO2sal was 0.85 kPa and precision 1.25 kPa. The disagreement between DPCO2gas and DPCO2sal increased with increasing dead space. We propose that the disagreement between the two methods studied may not be clinically important and that DPCO2gas may be a method for continuous estimation of splanchnic perfusion.

Br J Anaesth 2000; 85: 563–9

* Corresponding author: Department of Anesthesiology and Intensive Care, Division of Critical Care, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland


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