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Abstract
Bioengineering
ERRATUM NOTICE
Important: There has been an erratum issued for this article. Read more …Up to 50% of patients with trauma develop acute kidney injury (AKI), in part due to poor renal perfusion after severe blood loss. AKI is currently diagnosed based on a change in serum creatinine concentration from baseline or prolonged periods of decreased urine output. Unfortunately, baseline serum creatinine concentration data is unavailable in most patients with trauma, and current estimation methods are inaccurate. In addition, serum creatinine concentration may not change until 24-48 h after the injury. Lastly, oliguria must persist for a minimum of 6 h to diagnose AKI, making it impractical for early diagnosis. AKI diagnostic approaches available today are not useful for predicting risk during the resuscitation of patients with trauma. Studies suggest that urinary partial pressure of oxygen (PuO2) may be useful for assessing renal hypoxia. A monitor that connects the urinary catheter and the urine collection bag was developed to measure PuO2 noninvasively. The device incorporates an optical oxygen sensor that estimates PuO2 based on luminescence quenching principles. In addition, the device measures urinary flow and temperature, the latter to adjust for confounding effects of temperature changes. Urinary flow is measured to compensate for the effects of oxygen ingress during periods of low urine flow. This article describes a porcine model of hemorrhagic shock to study the relationship between noninvasive PuO2, renal hypoxia, and AKI development. A key element of the model is the ultrasound-guided surgical placement in the renal medulla of an oxygen probe, which is based on an unsheathed optical microfiber. PuO2 will also be measured in the bladder and compared to the kidney and noninvasive PuO2 measurements. This model can be used to test PuO2 as an early marker of AKI and assess PuO2 as a resuscitative endpoint after hemorrhage that is indicative of end-organ rather than systemic oxygenation.
Erratum
Erratum: Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic ShockAn erratum was issued for: Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock. The Protocol section was updated.
Step 2.3.1Â -Â 2.3.1.2Â of the Protocol was updated from:
to:
Step 2.3.2.2Â -Â 2.3.2.7Â of the Protocol was updated from:
to:
The Table of Materials was updated from:
Name | Company | Catalog Number | Comments |
1/8" PVC tubing | Qosina | SKU: T4307 | Part of noninvasive PuO2 monitor |
3/16" PVC tubing | Qosina | SKU: T4310 | Part of noninvasive PuO2 monitor |
3/32" (1), 1/8" (1), 5/32" (1) drill bit | Dewalt | N/A | For building noninvasive PuO2 monitor |
3/8" TPE tubing | Qosina | SKU: T2204 | Part of noninvasive PuO2 monitor |
Biocompatible Glue | Masterbond | EP30MED | Part of noninvasive PuO2 monitor |
Bladder oxygen measurement device | Presens | Fibox 4 | Stand-alone fiber optic oxygen meter |
Bladder PuO2 sensor | Presens | DP-PSt3 | Oxygen dipping probe |
Chlorhexidine 4% scrub | Vetone | N/A | For scrubbing insertion or puncture sites |
Conical connector with female luer lock | Qosina | SKU: 51500 | Part of noninvasive PuO2 monitor |
Cuffed endotracheal tube | Vetone | 600508 | For sedating the subject and providing respiratory support |
Euthanasia solution (pentobarbital sodium|pheyntoin sodium) | Vetone | 11168 | For euthanasia after completion of experiment |
General purpose temperature probe, 400 series thermistor | Novamed | 10-1610-040 | Part of noninvasive PuO2 monitor |
Hemmtop Magic Arm 11 inch | Amazon | B08JTZRKYN | Holding invasive oxygen sensor in place |
HotDog veterinary warming system | HotDog | V106 | For controlling subject temperature during experiment |
Invasive tissue oxygen measurement device | Presens | Oxy-1 STÂ | Compact oxygen transmitter |
Invasive tissue oxygen sensor | Presens | PM-PSt7 | Profiling oxygen microsensor |
Isoflurane | Vetone | 501017 | To maintain sedation throughout the experiment |
Isotonic crystalloid solution | HenrySchein | 1537930 or 1534612 | Used during resuscitation in the critical care period |
Liquid flow sensor | Sensirion | LD20-2600B | Part of noninvasive PuO2 monitor |
Male luer lock to barb connector | Qosina | SKU: 11549 | Part of noninvasive PuO2 monitor |
Male to male luer connector | Qosina | SKU: 20024 | Part of noninvasive PuO2 monitor |
Noninvasive oxygen measurement device | Presens | EOM-O2-mini | Electro optical module transmitter for contactless oxygen measurements |
Non-vented male luer lock cap | Qosina | SKU: 65418 | Part of noninvasive PuO2 monitor |
Norepinephrine | HenrySchein | AIN00610 | Infusion during resuscitation |
O2 sensor stick | Presens | SST-PSt3-YOP | Part of noninvasive PuO2 monitor |
PowerLab data acquisition platform | AD Instruments | N/A | For data collection |
REBOA catheter | Certus Critical Care | N/A | Used in experimental protocol |
Super Sheath arterial catheters (5 Fr, 7 Fr, 9 Fr) | Boston Scientific | C1894 | For intravascular access |
Suture | Ethicon | C013D | For securing catheter to skin and closing incisions |
T connector, all female luer locks | Qosina | SKU: 88214 | Part of noninvasive PuO2 monitor |
to:
Name | Company | Catalog Number | Comments |
1/8" PVC tubing | Qosina | SKU: T4307 | Part of noninvasive PuO2 monitor |
3/16" PVC tubing | Qosina | SKU: T4310 | Part of noninvasive PuO2 monitor |
3/8" TPE tubing | Qosina | SKU: T2204 | Part of noninvasive PuO2 monitor |
3/32" (1), 1/8" (1), 5/32" (1) drill bit | Dewalt | N/A | For building noninvasive PuO2 monitor |
Biocompatible Glue | Masterbond | EP30MED | Part of noninvasive PuO2 monitor |
Bladder PuO2 sensor | Presens | DP-PSt3 | Oxygen dipping probe |
Bladder oxygen measurement device | Presens | Fibox 4 | Stand-alone fiber optic oxygen meter |
Chlorhexidine 4% scrub | Vetone | N/A | For scrubbing insertion or puncture sites |
Conical connector with female luer lock | Qosina | SKU: 51500 | Part of noninvasive PuO2 monitor |
Cuffed endotracheal tube | Vetone | 600508 | For sedating the subject and providing respiratory support |
Euthanasia solution (pentobarbital sodium|pheyntoin sodium) | Vetone | 11168 | For euthanasia after completion of experiment |
General purpose temperature probe, 400 series thermistor | Novamed | 10-1610-040 | Part of noninvasive PuO2 monitor |
HotDog veterinary warming system | HotDog | V106 | For controlling subject temperature during experiment |
Invasive tissue oxygen measurement device | Optronix | N/A | OxyLiteâ„¢ oxygen monitors |
Invasive tissue oxygen sensor | Optronix | NX-BF/OT/E | Oxygen/Temperature bare-fibre sensor |
Isoflurane | Vetone | 501017 | To maintain sedation throughout the experiment |
Isotonic crystalloid solution | HenrySchein | 1537930 or 1534612 | Used during resuscitation in the critical care period |
Liquid flow sensor | Sensirion | LD20-2600B | Part of noninvasive PuO2 monitor |
Male luer lock to barb connector | Qosina | SKU: 11549 | Part of noninvasive PuO2 monitor |
Male to male luer connector | Qosina | SKU: 20024 | Part of noninvasive PuO2 monitor |
Norepinephrine | HenrySchein | AIN00610 | Infusion during resuscitation |
Noninvasive oxygen measurement device | Presens | EOM-O2-mini | Electro optical module transmitter for contactless oxygen measurements |
Non-vented male luer lock cap | Qosina | SKU: 65418 | Part of noninvasive PuO2 monitor |
O2 sensor stick | Presens | SST-PSt3-YOP | Part of noninvasive PuO2 monitor |
PowerLab data acquisition platform | AD Instruments | N/A | For data collection |
REBOA catheter | Certus Critical Care | N/A | Used in experimental protocol |
Super Sheath arterial catheters (5 Fr, 7 Fr, 9 Fr) | Boston Scientific | C1894 | for intravascular access |
Suture | Ethicon | C013D | For securing catheter to skin and closing incisions |
T connector, all female luer locks | Qosina | SKU: 88214 | Part of noninvasive PuO2 monitor |
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