Comparison of gastric mucosal pH and clinical judgement in critically ill patients

Joseph T. Santoso, David H Wisner, Felix D. Battistella, John T Owings

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: To compare gastric tonometry (pHi) with estimates of phi in ill injured patients, and to correlate phi with haemodynamic variables. Design: Prospective, non-interventional study. Setting: ICU of Level I trauma centre, USA. Main outcome measures: 154 gastric tonometry measurements were compared with physicians' estimates of adequacy of resuscitation. Resuscitation was categorised as inadequate (pHi < 7.35) or adequate (pHi ≤ 7.35). Measured and estimated phi were also compared with oxygen delivery, oxygen consumption, cardiac index, mixed venous O2 saturation, and critical illness scores. Results: Estimated pHi was often higher than measured phi in the judgement of all four surgical intensive care physicians. Measured phi correlated positively with mixed venous O2 tension (r = 0.21). There were significant negative correlations between measured phi and both oxygen delivery (r = -0.25) and oxygen consumption (r = -0.28). Estimated phi correlated positively with mean arterial pressure (r = 0.21) and hospital day (r = 0.26); it correlated negatively with pulmonary arterial elastance (r = - 0.35). Conclusion: Experienced intensive care physicians tended to overestimate visceral perfusion, which suggests that gastric tonometry adds useful information over and above routine haemodynamic indices. Arterial blood pressure and mixed venous oxygen saturation correlated better with measured phi than with other indices of perfusion.

Original languageEnglish (US)
Pages (from-to)521-526
Number of pages6
JournalEuropean Journal of Surgery
Volume164
Issue number7
DOIs
StatePublished - 1998

Fingerprint

Manometry
Critical Illness
Stomach
Critical Care
Oxygen
Physicians
Resuscitation
Oxygen Consumption
Arterial Pressure
Perfusion
Hemodynamics
Trauma Centers
Outcome Assessment (Health Care)
Lung

Keywords

  • Gastric tonometry
  • Perfusion
  • pHi
  • Resuscitation

ASJC Scopus subject areas

  • Surgery

Cite this

Comparison of gastric mucosal pH and clinical judgement in critically ill patients. / Santoso, Joseph T.; Wisner, David H; Battistella, Felix D.; Owings, John T.

In: European Journal of Surgery, Vol. 164, No. 7, 1998, p. 521-526.

Research output: Contribution to journalArticle

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