Investigation of muscle pH as an indicator of liver pH and injury from hemorrhagic shock
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Authors
Soller, Babs R.Khan, Tania N.
Favreau, Janice
Hsi, Charles
Puyana, Juan Carlos
Heard, Stephen O.
Student Authors
Tania KhanDocument Type
Journal ArticlePublication Date
2003-10-16
Metadata
Show full item recordAbstract
BACKGROUND: During hemorrhagic shock blood flow to vital organs is maintained by the diversion of blood from both the splanchnic organs and skeletal muscle. In this swine study, we tested the hypotheses that (1). liver and muscle pH are correlated during both shock and resuscitation and (2). muscle pH during shock is an indicator of potential liver injury after resuscitation. MATERIALS AND METHODS: Hemorrhagic shock was induced over 15 min to lower systolic blood pressure to 40 mm Hg and was maintained for 60 (n = 5) or 90 (n = 5) min. Resuscitation was achieved with shed blood and warm saline to maintain mean pressure >60 mm Hg for 120 min. Liver and muscle pH were measured with microelectrodes throughout the entire shock and resuscitation periods, along with hepatic venous oxygen saturation. Arterial lactate and aspartate aminotransferase were measured at baseline, end of shock, and resuscitation. Correlation between muscle and liver pH was determined. The ability of muscle pH to predict liver injury (40% increase in arterial aspartate aminotransferase) was compared with other predictors: liver pH, arterial lactate, and tonometric-arterial PCO(2) gap. RESULTS: pH values and rates of change were similar in both muscle and liver tissue. Liver pH was well correlated with muscle pH during both shock and resuscitation, R(2) = 0.84. Muscle pH predicts potential liver injury with the same sensitivity as blood lactate in this swine shock model. CONCLUSIONS: Minimally invasive measurement of muscle pH warrants further study as a method to assess splanchnic hypoperfusion and resultant injury.Source
J Surg Res. 2003 Oct;114(2):195-201.
DOI
10.1016/S0022-4804(03)00251-8Permanent Link to this Item
http://hdl.handle.net/20.500.14038/32578PubMed ID
14559446Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/S0022-4804(03)00251-8