To remain healthy, the tissues in the human body require constant and adequate delivery of blood and oxygen, known as tissue perfusion and oxygenation. When tissues are deprived of oxygen—a condition termed “hypoperfusion”—tissue hypoxia occurs and, if unattended, will lead to organ failure.
In critically ill or injured patients, tissue perfusion and oxygenation are essential in maintaining organ vitality and limiting the risk of multiple organ dysfunction syndrome (MODS) resulting from tissue hypoxia.
Patients with early warnings of failing tissue perfusion have better chances of recovery when treatment can be started promptly.1.2 Critical care providers need quick, non-invasive and reliable tools to assess microcirculation early and continuously to optimally manage hypoperfusion in critically ill patients.
Tissue pCO2—an abbreviation of “partial pressure of carbon dioxide”—indicates the amount of carbon dioxide gas dissolved in the blood. As an early indicator of tissue hypoperfusion, monitoring tissue pCO2 can provide life-saving information.
Gastric Carbon Dioxide: An Early Marker of Organ Hypoperfusion
Fortunately, there is an early marker of potential hypoperfusion: elevated partial pressure of carbon dioxide (pCO2) in the tissues of the gastrointestinal system. In combination with other hemodynamic markers, monitoring tissue pCO₂ can indicate tissue hypoperfusion and provide life-saving information.2
Buccal pCO2: A Non-invasive Measure of Convenience
ExoStat Medical has developed an easy-to-use device that measures pCO2 in oral mucosa. Studies have shown that oral mucosal pC02 correlates well with gastric pCO2 from tonometry.345 Unlike microcirculation tools such as tonometry and blood lactate measurements, POMCO2 is simple, noninvasive, and quick to measure.
In a study of 39 healthy subjects, the range of normal POMCO2 was 39-56 mmHg6 Patients with elevations above this range have been associated with poorer outcomes.7
1 Gutierrez G, et ai.Lancet 1992; 339: 195-199.
2 Marik PE. Chest 1993; 104:225-229.
3 Marik PE. Chest 2001 ; 120:923-927.
4 Rackow E, et a l. Chest 2001; 120:1633-1638.
5 Povoas H, et al. Chest 2000; 118:11 27-1132.
6 From a study of healthy volunteers, the normal value was a mean of 47.5 mmHg. Two standard deviations about the mean yield a normal range of 39-56 mmHg. Data on file at ExoStat Medical.
7 Weil MH, et al. Crit Care Med 1999; 27:1225-1229.