Sigmoid colonic reflectance pulse oximetry and tonometry in a porcine experimental hypoperfusion shock model.

BACKGROUND

The objective of the present study was to determine if colonic endoluminal mucosal oxygen saturation, as determined by reflectance pulse oximetry, is an appropriate method to monitor colonic ischemia produced by a gradual partial constriction of the aorta in a porcine experimental model.

METHODS

Piglets were anesthetized and mechanically ventilated. A Nellcor RS-10 reflectance pulse oximeter probe was attached to a Foley balloon catheter and passed transanally to record the oxygen saturation of the sigmoid colonic mucosa. For comparison, a tonometry catheter was introduced into the sigmoid colon. Hypoperfusion shock was induced by partial gradual constriction of the aorta. The same measurements but no intervention was performed in the control group.

RESULTS

During one-third reduction of the aortic blood flow, the plethysmographic signal disappeared suddenly and the sigmoid colonic mucosa oxygen saturation (ScO2) measurements showed zero in seven out of the eight pigs. During two-thirds flow reduction, no plethysmographic signals were observed in any of the piglets. During the reperfusion period, ScO2 measurements with a good plethysmographic signal were obtained immediately after complete release of the aortic constriction in all pigs. Significantly decreased intramucosal pH and increased difference between the arterial and regional PCO2 (PCO2 gap) were observed during two-thirds blood flow reduction.

CONCLUSION

In contrast to the results of previous investigations, the sigmoid colonic pulse oximetry was not useful because the method proved to be overly sensitive and non-linear in relation to regional blood flow.