Decreases in organ blood flows associated with increases in sublingual PCO2 during hemorrhagic shock

Earlier studies demonstrated that not only thestomach but also the esophageal wall served as an appropriate site forestimating the severity of circulatory shock by using tonometricmethods. We then conceived of the option of sublingual tonometry. Inthe present study, we tested the hypothesis that the changes insublingual PCO₂ serve as indicatorsof decreases in blood flow to sublingual and visceraltissue. In Sprague-Dawley rats, sublingual PCO₂ increased from 50 to 127 Torrand arterial blood lactate increased from 0.9 to 11.2 mmol/l duringbleeding. Sublingual blood flow simultaneously decreased to ~32% ofpreshock values. After reinfusion of shed blood, organ blood flows andsublingual PCO₂ were promptlyrestored to near-baseline values. There were corresponding decreases inblood flows in the tongue, stomach, jejunum, colon, and kidneys duringhemorrhagic shock. Increases in sublingualPCO₂ were highly correlated with decreases in sublingual blood flow (r = 0.80), tongue blood flow (r = 0.81),gastric blood flow (r = 0.74), jejunalblood flow (r = 0.65), colon bloodflow (r = 0.80), and renal blood flow (r = 0.75). Unbled control animalsdemonstrated no significant changes. Therefore, we anticipate thatsublingual tonometry will provide a useful, noninvasive alternative formonitoring visceral PCO₂.