Cardiorespiratory and conjunctival oxygen tension monitoring during crystalloid resuscitation after hemorrhage

Abstract

Conjunctival oxygen tension (Pcj0 2) monitoring provides a continuous, noninvasive assessment of tissue oxygenation and perfusion. In this study, the relationship between Pcj0 2 and standard cardiorespiratory variables was examined during sequential, stepwise crystalloid resuscitation after acute hemorrhage to a mean arterial pressure (MAP) of 40 mm Hg. Posthemorrhage values for Pcj0 2 were approximately 5% of prehemorrhage values. Blood pressure rose rapidly during the early stages of resuscitation, and after 40% of the shed blood volume had been replaced with crystalloid was no longer significantly different from prehemorrhage values. Pcj0 2 rose in a linear manner during resuscitation and achieved values that were not significantly different from control when 70% of the shed blood volume had been replaced with crystalloid. When all of the shed blood volume had been replaced with crystalloid, cardiac index, left and right cardiac work index, and oxygen delivery remained significantly less than control levels. These results indicate that PcjO 2 normalizes before crystalloid resuscitation is complete, but after blood pressure and other noninvasively measured parameters return to prehemmorrhage levels.