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Biomedical subjects

M Haisjackl

Publications and source records attributed to M Haisjackl.

28 records · Page 2Linked to original sources
PubMed1994

Dopamine and mucosal oxygenation in the porcine jejunum.

The effect of intravenously delivered dopamine on jejunal tissue oxygenation was studied in 12 pigs anesthetized with midazolam and sufentanil and mechanically ventilated. A small segment of the jejunal mucosa and serosa was exposed by midline laparotomy and antimesenteric incision. Mucosal and serosal tissue PO2, mucosal microvascular hemoglobin oxygen saturation, and mucosal hemoglobin concentration were measured by means of Clark-type oxygen electrodes and tissue reflectance spectrophotometry, respectively. In five animals electromyogenic potentials of the jejunal wall were recorded. Measurements were performed under baseline conditions and after intravenous infusion of 2, 4, 8, 16, 32, and again 2 micrograms.kg-1.min-1 of dopamine. The drug produced a dose-related increase in mucosal PO2 (from 26.5 Torr at baseline to 49 Torr at 32 micrograms of dopamine; P < 0.001) and mucosal hemoglobin oxygen saturation (from 55.1 to 70.1%; P < 0.03) but no change in serosal PO2 (from 70.6 to 65.5 Torr). In nine animals baseline mucosal PO2 and mucosal hemoglobin oxygen saturation showed rhythmic oscillations with a frequency of 2.5-5 cycles/min that could not be related to electromyogenic potentials. Dopamine decreased the oscillation amplitude of these two parameters (P < 0.001), and at doses > 16 micrograms.kg-1.min-1 they were no longer present. Dopamine therefore improves mucosal oxygenation of the porcine jejunum in a selective and dose-related manner. At higher doses the preexisting oscillatory pattern of mucosal oxygenation, which is most likely due to vasomotion, is impeded.

Animals↗
PubMed1991

Factors influencing transcutaneous oxygen and carbon dioxide measurements in adult intensive care patients.

Transcutaneous PO2 (PtcO2) is suggested to reflect tissue oxygenation in intensive care patients, whereas transcutaneous PCO2 (PtcCO2) is advocated as a noninvasive method for assessing PaCO2. In 24 critically ill adult patients (mean Apache II score 14.2, SD 4.7) we investigated the impact of variables that are commonly thought to determine PtcO2 and PtcCO2 measurements. A linear correlation was found between PtcO2 and PaO2 (r = 0.6; p less than or equal to 0.0001) and between PtcO2 and mean arterial blood pressure (MAP; r = 0.42; p less than or equal to 0.003). Cardiac index (CI) correlated with tc-index (PtcO2/PaO2; r = 0.31; p less than or equal to 0.03). There was no relationship between PtcO2 and hemoglobin concentration (Hb) and the position of the oxygen dissociation curve (ODC). Stepwise multiple regression analysis demonstrated a significant influence of PaO2 and MAP on PtcO2. The contribution of CI, Hb and the ODC was not significant. Only 40% of the variability of a single PtcO2 measurement could be explained by PaO2 and MAP. A significant linear correlation was demonstrated between PtcCO2 and PaCO2 (r = 0.76; p less than or equal to 0.0001) but not between PtcCO2 and CI, MAP and arterial base excess (BEa). Stepwise multiple regression analysis revealed an influence of PaCO2 and of CI on PtcCO2; 66% of the variability of a single PtcCO2-value could be explained by PaCO2 and CI. Our data demonstrate that transcutaneous derived gas tensions result from complex interaction between hemodynamic, respiratory and local factors, which can hardly be defined in ICU-patients.

Adult↗
PubMed1990

Diminished reactive hyperemia in the skin of critically ill patients.

Reactive hyperemia (RH) in the forearm skin after an arterial occlusion of 5 min was investigated in 29 ICU patients and 17 age-matched healthy control subjects using a transcutaneous PO2/PCO2 electrode heated to 37 degrees C. There was no difference in preocclusive baseline PtCO2 between patients (8 +/- 5 torr) and control subjects (8 +/- 4 torr). Patients exhibited a significantly decreased RH (16 +/- 9 torr) in comparison with control subjects (26 +/- 8 torr) and a diminished CO2 elimination. There was no correlation between the RH response and the oxygen extraction ratio, Hgb concentration, and hemodynamic and blood gas variables in patients. In contrast with control subjects, there was a significant correlation between CO2 elimination from the skin and the amount of RH in patients. The finding of a diminished RH in the patients was not related to a specific disease but correlated with the degree of physiologic derangement as assessed by the APACHE II score.

Adolescent↗
PubMed1989

[The use of a transcutaneous pO2/pCO2 combination electrode during volume therapy in a child in shock].

We report a 1-year-old boy in hemorrhagic shock due to a large subgaleatic hematoma following severe head trauma (blood pressure (BP) 30/15 mmHg; heart rate (HR) 110; Hb 45 g/l; arterial pH 7.16; BE-20 mEq/l). The child was intubated and ventilated; initial FIO2 was 0.9. In an attempt to monitor the cardiovascular system noninvasively a transcutaneous oxygen/carbon dioxide combielectrode was placed on the chest. Initially we observed a large difference between arterial pO2 (paO2 = 166 mmHg) and transcutaneous pO2 (tcpO2 = 7 mmHg) and arterial pCO2 (paCO2 = 16 mmHg) and transcutaneous pCO2 (tcpCO2 = 55 mmHg), reflecting poor skin perfusion and severe tissue acidosis. Under aggressive volume replacement tcpO2 rose along with BP and tcpCO2 returned to near arterial values. Even after stabilization of gross hemodynamic parameters such as HR and BP and despite reductions in FIO2, tcpO2 continued to increase with further volume replacement, reflecting an existing volume deficit.

Blood Gas Monitoring, Transcutaneous↗