ADEQUACY OF TISSUE OXYGENATION

Objective: This paper reviews presently available techniques for monitoring the adequacy of tissue oxygenation, emphasizing the practical and theoretical problems that exist with presently used measurements. Data Sources: The data are based on a review of the literature. Data Synthesis: Most of the presently available techniques focus on global measurements of oxygen transport and utilization that may be insensitive to changes occurring in vital tissues critically important to overall homeostasis. As a result, they are often insensitive, nonspecific, and become abnormal only at a very late stage of disease. Conclusions: In attempting to develop tools to assess adequate tissue oxygenation, emphasis should be placed on the monitoring of individual tissues that are felt to be highly susceptible to reduced oxygen delivery and key to overall survival. Preliminary data involving measurements of the interstitial pH of the gastrointestinal tract suggest that this measurement may be one approach to pursue.