TY - JOUR
T1 - Does peritoneal ventilation with 100% oxygen (PV-O2) during and after severe hemorrhagic shock (HS) protect viscera and improve outcome? A preliminary study in rats
AU - Barr, Joseph
AU - Prueckner, Stephan
AU - Safar, Peter
AU - Tisherman, Samuel A.
AU - Stezoski, Jason
PY - 1999
Y1 - 1999
N2 - Introduction: In experimental pulmonary consolidation with hypoxemia, 100% oxygen insufflation into the peritoneal cavity improved PaO2. O2 ventilation further improved PaO2. We hypothesized that PV-O2 may mitigate critical dysoxia in abdominal viscera during and after severe HS, and thereby improve outcome after all-out fluid resuscitation (FR). Methods: 12 rats under light halothane anesthesia and spontaneous breathing of air underwent blood withdrawal of 3 ml/100g over 15 min. After volume-controlled HS of 60 min, all-out FR with controlled normotension over 1 h was followed by observation to 7 d. We studied 2 groups of 6 rats each: control group I without PV-O2; and group II with PV-O2, which received ventilation with 100% O2 of the peritoneal cavity, via a 14F catheter, at a rate of 40/min, with "tidal volumes" of 6 ml/rat. Normothermia was controlled throughout. Results: In group 2, during PV-O2 (compared to controls), MAP was higher (p < 0.05); and pHa was less depressed (p < 0.05). Survival time in the 6 rats of control group I was 20 h, 36 h, 108 h, 7 d, 7 d, 7 d. All 6 rats of PV-O2 group II survived to sacrifice at 7 d. Survival rate to 7 d was 3 of 6 rats in control group II, vs 6 of the 6 rats in PV-O2 group II. Gross necropsy showed necrotic intestine in 4 of the 6 rats in control group I, and in none of the 6 rats of PV-O2 group II. Discussion: There is a suggestion that PV-O2 might help preserve viability of the intestine during severe HS and thereby improve outcome. Many still unanswered questions provoked by this observation include: Does PV-O2 increase PO2 in portal and hepatic vein blood? What is the effect of peritoneal continuous O2 insufflation vs ventilation? Could the preservation of the intestines be further enhanced by intraluminal gastrointestinal O2 insufflation? Would increased PO2 in the portal vein help mitigate liver damage from HS? Does the beneficial effect of PV-O2 occur more during or after HS?
AB - Introduction: In experimental pulmonary consolidation with hypoxemia, 100% oxygen insufflation into the peritoneal cavity improved PaO2. O2 ventilation further improved PaO2. We hypothesized that PV-O2 may mitigate critical dysoxia in abdominal viscera during and after severe HS, and thereby improve outcome after all-out fluid resuscitation (FR). Methods: 12 rats under light halothane anesthesia and spontaneous breathing of air underwent blood withdrawal of 3 ml/100g over 15 min. After volume-controlled HS of 60 min, all-out FR with controlled normotension over 1 h was followed by observation to 7 d. We studied 2 groups of 6 rats each: control group I without PV-O2; and group II with PV-O2, which received ventilation with 100% O2 of the peritoneal cavity, via a 14F catheter, at a rate of 40/min, with "tidal volumes" of 6 ml/rat. Normothermia was controlled throughout. Results: In group 2, during PV-O2 (compared to controls), MAP was higher (p < 0.05); and pHa was less depressed (p < 0.05). Survival time in the 6 rats of control group I was 20 h, 36 h, 108 h, 7 d, 7 d, 7 d. All 6 rats of PV-O2 group II survived to sacrifice at 7 d. Survival rate to 7 d was 3 of 6 rats in control group II, vs 6 of the 6 rats in PV-O2 group II. Gross necropsy showed necrotic intestine in 4 of the 6 rats in control group I, and in none of the 6 rats of PV-O2 group II. Discussion: There is a suggestion that PV-O2 might help preserve viability of the intestine during severe HS and thereby improve outcome. Many still unanswered questions provoked by this observation include: Does PV-O2 increase PO2 in portal and hepatic vein blood? What is the effect of peritoneal continuous O2 insufflation vs ventilation? Could the preservation of the intestines be further enhanced by intraluminal gastrointestinal O2 insufflation? Would increased PO2 in the portal vein help mitigate liver damage from HS? Does the beneficial effect of PV-O2 occur more during or after HS?
UR - http://www.scopus.com/inward/record.url?scp=4244157752&partnerID=8YFLogxK
U2 - 10.1097/00003246-199901001-00381
DO - 10.1097/00003246-199901001-00381
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AN - SCOPUS:4244157752
SN - 0090-3493
VL - 27
SP - A136
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 1 SUPPL.
ER -