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The influence of different levels of PEEP on peripheral tissue perfusion measured by subcutaneous and transcutaneous oxygen tension

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Abstract

Objective

To compare subcutaneous (PscO2) and transcutaneous (PtcO2) oxygen tension measurements in relation to hemodynamic variables at different levels of PEEP, and to evaluate the usefulness of these measurements as monitors of peripheral tissue perfusion.

Design

Prospective trial.

Setting

Intensive care unit in a university hospital.

Patients

Seven patients with gastric cancer who where undergoing total gastrectomy.

Interventions

Silicone catheter was placed in the upper arm and transcutaneous oxygen monitor was placed on the upper part of the chest. A pulmonary artery catheter was placed in the right pulmonary artery.

Measurements and results

PscO2 and PtcO2 together with hemodynamic variables were measured at different levels of PEEP. Progressive increase of PEEP reduced cardiac index (CI) (p<0.05) with a concomitant decrease of PscO2 (p<0.05) and oxygen delivery (DO2) (p<0.05). Changes in PtcO2 parallelled changes in arterial oxygen tension (PaO2), but no correlation was found between PtcO2, CI and DO2.

Conclusion

PscO2 is a sensitive indicator of subcutaneous tissue perfusion, which can be used to identify the PEEP level, with optimum peripheral perfusion. PscO2 seems to be a more reliable indicafor of tissue perfusion than PtcO2.

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Authors and Affiliations

  1. Department of Anaesthesiology, Malmö General Hospital, University of Lund, S-21401, Malmö, Sweden

    M. Hartmann & B. Rosberg

  2. Department of Surgery, Malmö General Hospital, University of Lund, Malmö, Sweden

    K. Jönsson

Authors
  1. M. Hartmann
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  2. B. Rosberg
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  3. K. Jönsson
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Additional information

This study was supported by Tore Nilsons Fund for Medical Research. Lundgrens Stiftelse, Medical Faculty, University of Lund and by the Swedish Medical Research Council Projecr no. B88-17x-00640-24B

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Hartmann, M., Rosberg, B. & Jönsson, K. The influence of different levels of PEEP on peripheral tissue perfusion measured by subcutaneous and transcutaneous oxygen tension. Intensive Care Med 18, 474–478 (1992). https://doi.org/10.1007/BF01708584

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  • DOI: https://doi.org/10.1007/BF01708584

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