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David D. Zabel, MD; Harriet W. Hopf, MD; Thomas K. Hunt, MD

Arch Surg. 1995;130(1):59-63.

Abstract
Objectives
To develop a reproducible model to measure transmural gut tissue PO₂, to determine the gradient from serosa to mucosa during normovolemia and hypovolemia, and to determine the effect of resuscitation with heparan sulfate (danaparoid sodium) on this gradient.

Design
Fluorescent tissue oxygen sensors were placed onto serosal and mucosal surfaces of rat colon. Hemorrhagic shock was induced using a fixed pressure (mean arterial pressure, 40 mm Hg) model and resuscitated with either saline solution or heparan.

Results
Control animals had stable mean (±SD) serosal and mucosal tissue oxygen tensions (PO₂) of 64±4 and 10±2 mm Hg, respectively. In shocked animals, baseline serosal PO₂ decreased to 37±2 mm Hg at a mean (±SD) of 19±7 minutes after the initiation of hemorrhage. Mucosal values decreased to a minimum of 4±2 mm Hg at 45±15 minutes after the initiation of hemorrhage. Serosal PO₂ returned to baseline during resuscitation in both control and heparanresuscitated animals. Mucosal PO₂ did not return to baseline in the shock/no heparan group. In the heparan-resuscitated animals, however, mucosal PO2 increased above baseline (13±3 mm Hg at 3 hours after completion of hemorrhage).

Conclusions
A transmural gradient of PO₂ exists across the colon with mucosal PO₂ far lower than serosal PO₂. Both serosal and mucosal PO₂ decrease during hypovolemia. During hypovolemia, the PO₂ of the entire gut wall is in a range in which phagocytic killing is impaired by hypoxia. Heparan improved mucosal PO₂ and it may restore and/or protect gut function by oxygen-related mechanisms.

(Arch Surg. 1995;130:59-63)

Author Affiliations
From the Departments of Surgery (Drs Zabel, Hopf, and Hunt) and Anesthesia (Dr Hopf), University of California—San Francisco.

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