Diagnostic utility of sublingual PCO2 for detecting hemorrhage in penetrating trauma patients

J Trauma. 2004 Jul;57(1):69-74. doi: 10.1097/01.ta.0000090754.94232.2c.

Abstract

Background: Hemorrhage results in early compromise of splanchnic circulation. Studies have shown that sublingual Pco2 (SLCO2) correlates with gut perfusion. We tested SLCO2's ability to detect hemorrhage. We compared SLCO2 with arterial base deficit (BD) and lactate (LAC).

Methods: This was a prospective study of patients with penetrating torso trauma. SLCO2 was measured at triage. Blood loss was defined as none (group 1), minimal to moderate (<1,500 mL) (group 2), or severe (>/=1,500 mL) (group 3). Data were reported as mean (95% confidence interval) and compared by analysis of variance. Receiver operating characteristic curves compared diagnostic performance between SLCO2, BD, and LAC.

Results: One hundred eight patients were enrolled. There was a significant difference (p < 0.001) in SLCO2 between all blood loss groups: group 1, 46.9 mm Hg (44.9-49.0 mm Hg); group 2, 53.5 mm Hg (50.8-56.2 mm Hg); and group 3, 66.0 mm Hg (53.1-78.9 mm Hg). There were no significant (p > 0.05) differences for receiver operating characteristic curves between SLCO2, BD, or LAC.

Conclusion: SLCO2 differentiated blood loss groups. SLCO2 may be useful in triage of penetrating trauma patients.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Baltimore / epidemiology
  • Blood Gas Monitoring, Transcutaneous / methods*
  • Carbon Dioxide / analysis*
  • Female
  • Humans
  • Lactic Acid / blood
  • Male
  • Mouth Floor
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Shock, Hemorrhagic / blood
  • Shock, Hemorrhagic / diagnosis*
  • Shock, Hemorrhagic / etiology
  • Wounds, Penetrating / complications*
  • Wounds, Penetrating / epidemiology

Substances

  • Carbon Dioxide
  • Lactic Acid