15. Monitoring Tissue Perfusion: Clinicopathologic Aids and Advanced Techniques

  1. DVM, DACVECC Jamie M. Burkitt Creedon1 and
  2. BA, RVT, VTS (ECC) (Anesth) Harold Davis2
  1. Brian C. Young

Published Online: 18 JUL 2014

DOI: 10.1002/9781118997246.ch15

Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care

Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care

How to Cite

Young, B. C. (2012) Monitoring Tissue Perfusion: Clinicopathologic Aids and Advanced Techniques, in Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care (eds J. M. Burkitt Creedon and H. Davis), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781118997246.ch15

Editor Information

  1. 1

    Chief, Emergency and Critical Care Service Red Bank Veterinary Hospital, Cherry Hill Cherry Hill, New Jersey

  2. 2

    Manager, Emergency and Critical Care Service William R. Pritchard Veterinary Medical Teaching Hospital University of California, Davis Davis, California

Publication History

  1. Published Online: 18 JUL 2014
  2. Published Print: 8 JUN 2012

ISBN Information

Print ISBN: 9780813813370

Online ISBN: 9781118997246

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Keywords:

  • blood lactate concentration;
  • global perfusion;
  • microcirculation;
  • nicotinamide adenine dinucleotide;
  • oxygen extraction ratio;
  • small animal;
  • tissue perfusion;
  • venous oximetry

Summary

Monitoring perfusion always begins with an initial physical examination of the patient at presentation and continues with serial examinations thereafter. Research laboratories, emergency departments, operating suites, and intensive care units have begun to develop and utilize tools to elucidate the condition of the microcirculation in an attempt to identify occult shock and restore or maintain optimal tissue perfusion. This chapter introduces these techniques and discusses their clinical applications. “Downstream” markers of perfusion represent indicators of organ function, global perfusion, or regional perfusion. They include urine output (UOP), blood lactate concentration, lactate clearance, base deficit (BD), oxygen consumption (VO2), venous oximetry, oxygen extraction ratio (O2ER), nicotinamide adenine dinucleotide ratio (NADH : NAD), gastric mucosal pH (pHi), sublingual tonometry (PslCO2), orthogonal polarization spectral (OPS) imaging, near-infrared spectroscopy (NIRS), and tissue O2/CO2 monitoring. Blood lactate measurements are readily accessible in veterinary medicine using blood gas machines.