Monitoring Tissue Ischemia After Potentially Life Threatening Post- Traumatic Injuries

摘要

Hemorrhagic shock remains the dominant cause of death after both battlefield and civilian trauma. The conventional management of fluid resuscitation titrated to normal levels of blood pressure may increase mortality. Fluid resuscitation during hemorrhagic shock is therefore best based on more specific measurements indicating adequacy or inadequacy of tissue perfusion rather than on arterial (blood) pressure levels. This research sought to develop and optimize a nanosensor as a monitoring device of tissue PCO2, and to examine the measurement of sublingual PCO2 (PSLCO2) as a quantitative indicator of tolerable or intolerable acute blood loss as a basis for refining therapeutic strategies for volume repletion. The first stage of the study was to develop a PSLCO2 sensor based on the existing Sensation platform. The Sensation carbon nanotube sensor technology provides a flexible platform with improved signal-to-noise ratio and accuracy utilizing a simple reader design with low power requirements. Results show that the measurement of PSLCO2 provided a significantly better indicator of the severity of tissue ischemia and, therefore, a better guide for optimizing fluid resuscitation. It is especially significant for the military application since it will avoid unnecessary fluid replacement when the resource is extremely limited in the battlefield. The sensor is now developed and is ready to be tested in our pig model of hemorrhagic shock.