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Evaluation and Clinical Application

Joseph M. Van De Water, MD; Peter A. Philips, MD; Larry A. Linton; Richard W. Borst; William R. Fisher

AMA Arch Surg. 1972;104(6):799-805.

Abstract
Experiments were carried out in a canine model to test the validity of skeletal muscle surface pH (pH_M) measurements in predicting imbalances in the relationship of perfusion to metabolic demand. Under conditions of metabolic and respiratory alkalosis and acidosis, there were no perfusion deficits and pH_M paralleled arterial pH (pHa). Graded hemorrhage, however, resulted in an early drop in pH_M coincident with decreased arterial flow to the extremities long before there was any change in pHa or systemic blood pressure. A description of the clinical application of pH_M monitoring, with examples, is included and illustrated by examples of its value in hypovolemia, regulation of flow in cardiopulmonary bypass, and in malposition of the arm.

Author Affiliations
Duarte, Calif

From the Department of Thoracic and Cardiovascular Surgery, City of Hope National Medical Center, Duarte, Calif.

Footnotes
Accepted for publication Feb 15, 1972.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Santa Barbara, Calif, Jan 14,1972.

Reprint requests to Chief, Thoracic and Cardiovascular Surgery, Charles R. Drew Postgraduate Medical School, 1620 E 119th St, Los Angeles 90059 (Dr. Van De Water).

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