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PaO(2) oscillations caused by cyclic alveolar recruitment can be monitored in pig buccal mucosa microcirculation.
MedLine Citation:
PMID:  23167550     Owner:  NLM     Status:  Publisher    
BACKGROUND: Cyclic alveolar recruitment and derecruitment play a role in the pathomechanism of acute lung injury and may lead to arterial partial pressure of oxygen (PaO(2) ) oscillations within the respiratory cycle. It remains unknown, however, if these PaO(2) oscillations are transmitted to the microcirculation. The present study investigates if PaO(2) oscillations can be detected in the pig buccal mucosa microcirculation. METHODS: Respiratory failure was induced by surfactant depletion in seven pigs. PaO(2) oscillations caused by cyclic recruitment and derecruitment were measured in the thoracic aorta by fast fluorescence quenching of oxygen technology. Haemoglobin oxygen saturation, haemoglobin amount and blood flow in the buccal mucosa microcirculation were determined by combined fast white light spectrometry and laser Doppler flowmetry additionally to systolic arterial pressure. Measurements were performed during baseline conditions and during cyclic recruitment and derecruitment. RESULTS: Measurements remained stable during baseline. Respiratory-dependent oscillations occurred in the systemic circulation [PaO(2) oscillations 92 (69-172) mmHg; systolic arterial pressure oscillations 33 (13-35) %] and were related to the respiratory rate (5.0 ± 0.2/min) as confirmed by Fourier analysis. Synchronised oscillations were detected to the pig buccal mucosa microcirculation [haemoglobin oxygen saturation oscillations 3.4 (2.7-4.9) %; haemoglobin amount oscillations 8.5 (2.3-13.3) %; blood flow oscillations 66 (18-87) %]. The delay between PaO(2) -\ and microcirculatory oxygen oscillations was 7.2 ± 2.8 s. CONCLUSION: The present study suggests that PaO(2) oscillations caused by cyclic recruitment and derecruitment were transmitted to the buccal mucosa microcirculation. This non-invasive approach of measuring oxygen waves as a surrogate parameter of cyclic recruitment and derecruitment could be used to monitor PaO(2) oscillations at the bedside.
K U Klein; E K Hartmann; S Boehme; M Szczyrba; L Heylen; T Liu; M David; C Werner; K Markstaller; K Engelhard
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-21
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  -     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.
Department of Anaesthesiology, Medical Center of the Johannes Gutenberg-University, Mainz, Germany; Department of Anaesthesia, General Intensive Care and Pain Management, Medical University Vienna, Vienna, Austria.
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