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GENERAL ARTICLES

Supplemental Oxygen, but Not Supplemental Crystalloid Fluid, Increases Tissue Oxygen Tension in Healthy and Anastomotic Colon in Pigs

Oliver Kimberger, MD^*, Edith Fleischmann, MD, Sebastian Brandt, MD^*, André Kugener, MD, Barbara Kabon, MD, Luzius Hiltebrand, MD^*, Vladimir Krejci, MD^*, and Andrea Kurz, MD^*

From the *Department of Anesthesiology, University of Bern, Switzerland; Department of Anesthesia and General Intensive Care, Division of Cardiothoracic and Vascular Anesthesia and Intensive Care, and Department of Anesthesia and General Intensive Care, Medical University Vienna, Austria; and Outcomes Research Institute, University of Louisville, Louisville, Kentucky.

Address correspondence to Oliver Kimberger, MD, Department of Anesthesiology, University of Bern, Switzerland. Address e-mail to study{at}kimberger.at or www.or.org.

BACKGROUND: Low tissue oxygen tension is an important factor leading to the development of wound dehiscence and anastomotic leakage after colon surgery. We tested whether supplemental fluid and supplemental oxygen can increase tissue oxygen tension in healthy and injured, perianastomotic, and anastomotic colon in an acutely instrumented pig model of anastomosis surgery.

METHODS: Sixteen Swiss Landrace pigs were anesthetized (isoflurane 0.8%–1%) and their lungs ventilated. The animals were randomly assigned to low fluid treatment ("low" group, 3 mL · kg^–1 · h^–1 lactated Ringer’s solution) or high fluid treatment ("high" group, 10 mL/kg bolus, 18 mL · kg^–1 · h^–1 lactated Ringer’s solution) during colon anastomosis surgery and a subsequent measurement period (4 h). Two-and-half hours after surgery, tissue oxygen tension was recorded for 30 min during ventilation with 30% oxygen. Three hours after surgery, the animals’ lungs were ventilated with 100% oxygen for 60 min. Tissue oxygen tension was recorded in the last 30 min. Tissue oxygen tension was measured with polarographic Clark-type electrodes, positioned in healthy colonic wall, close (2 cm) to the anastomosis, and in the anastomosis.

RESULTS: In every group, tissue oxygen tension during ventilation with 100% oxygen was approximately twice as high as during ventilation with 30% oxygen, a statistically significant result. High or low volume crystalloid fluid treatment had no effect on colon tissue oxygen tension.

CONCLUSIONS: Supplemental oxygen, but not supplemental crystalloid fluid, increased tissue oxygen tension in healthy, perianastomotic, and anastomotic colon tissue.