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BioMed Research International
Volume 2015, Article ID 847152, 10 pages
Research Article

Monitoring Microcirculatory Blood Flow with a New Sublingual Tonometer in a Porcine Model of Hemorrhagic Shock

1Department of Anesthesiology and Intensive Therapy, University of Szeged, 6 Semmelweis Street, Szeged 6725, Hungary
2Institute of Surgical Research, University of Szeged, 6 Szőkefalvi-Nagy Béla Street, Szeged 6720, Hungary

Received 21 January 2015; Revised 23 March 2015; Accepted 24 March 2015

Academic Editor: Stephen M. Cohn

Copyright © 2015 Péter Palágyi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Tissue capnometry may be suitable for the indirect evaluation of regional hypoperfusion. We tested the performance of a new sublingual capillary tonometer in experimental hemorrhage. Thirty-six anesthetized, ventilated mini pigs were divided into sham-operated () and shock groups (). Hemorrhagic shock was induced by reducing mean arterial pressure (MAP) to 40 mmHg for 60 min, after which fluid resuscitation started aiming to increase MAP to 75% of the baseline value (60–180 min). Sublingual carbon-dioxide partial pressure was measured by tonometry, using a specially coiled silicone rubber tube. Mucosal red blood cell velocity (RBCV) and capillary perfusion rate (CPR) were assessed by orthogonal polarization spectral (OPS) imaging. In the 60 min shock phase a significant drop in cardiac index was accompanied by reduction in sublingual RBCV and CPR and significant increase in the sublingual mucosal-to-arterial PCO2 gap ( gap), which significantly improved during the 120 min resuscitation phase. There was significant correlation between gap and sublingual RBCV (, ), CPR (, ), central venous oxygen saturation (, ), and central venous-to-arterial PCO2 difference (, ). This new sublingual tonometer may be an appropriate tool for the indirect evaluation of circulatory changes in shock.