Gastric intramucosal pH (phî) driven resuscitation and antioxidants

normalized phi is associated with high survival

O. Kirton, J. Civetta, J. Hudson-Civena, E. Gomez, David V Shatz, M. McKenney, P. Byers, E. Ginzburg, J. Augenstein, O. Sleeman, B. Dehaven

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: Low mucosal lonoroetric pH has been shown to be highly predictive of mortality in general and trauma ICU patients. Methods: Prospective 3 month study of critically injured blunt and penetrating admissions to a Level 1 Trauma ICU. Hemodynamk optimization was based on achieving pHi > 7.25, including the use of splanchnic-sparing vasopressors (e.g., dobutamine, dopamine, etc.). All patients received intravenous doses of mannitol, folate, Iklocaine, vitamin C. selenium, polymyxin B and hydrocortisone, [n addition. Vitamin A and E phis glutamine and N-acetylcysteine were given by enterai route. If pHi became abnormal (Abn-pHi <725) post-normalization (Nonn-pHi;>7.25), the episode(s) was characterized as a fluctuation (Flue). Data was analyzed by Cht-square. Results: 92 patients : (mearttSD) Trauma Score -14±2, ISS- 2716; CCS -13±3; APACHE II- I9±8. pHi Group Lived Died % Lived Cfci-Sq TVn.lPt. Q->A f. QjH EadNonn 87 84 3 97% g-H Ah 5 2 3 Start Abo 16 12 4 75V. St.rt Nnrm 76 74 > Always Nora 58 58 0 100% Always Aba 2 1 1 50% Ab_->nM-Norai 29 26 3 90% isiii->irii_2 2 2 054 < AbaAaytime 34 28 6 82% End Aba 523 40% End Norm 29 26 3 90% < .0399 14 of 16 abnormal pHi (88%) on admission normalized with the protocol. In this subset, overall mortality of normalized pHi was 3% (p<.001), compared to a 60% mortality in those patients with uncorrectable pHi (p<.001). Conclosion: Normalization of pHi using a pHi-driven protocol and administering agents to prevent and scavenge oxygen free-radicals in the critically-ill injured is associated with high survival.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume26
Issue number1 SUPPL.
StatePublished - 1998
Externally publishedYes

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Resuscitation
Stomach
Antioxidants
Survival
Mortality
Wounds and Injuries
Polymyxin B
Injury Severity Score
APACHE
Dobutamine
Viscera
Acetylcysteine
Mannitol
Selenium
Glutamine
Vitamin A
Vitamin E
Folic Acid
Critical Illness
Ascorbic Acid

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Kirton, O., Civetta, J., Hudson-Civena, J., Gomez, E., Shatz, D. V., McKenney, M., ... Dehaven, B. (1998). Gastric intramucosal pH (phî) driven resuscitation and antioxidants: normalized phi is associated with high survival. Critical Care Medicine, 26(1 SUPPL.).

Gastric intramucosal pH (phî) driven resuscitation and antioxidants : normalized phi is associated with high survival. / Kirton, O.; Civetta, J.; Hudson-Civena, J.; Gomez, E.; Shatz, David V; McKenney, M.; Byers, P.; Ginzburg, E.; Augenstein, J.; Sleeman, O.; Dehaven, B.

In: Critical Care Medicine, Vol. 26, No. 1 SUPPL., 1998.

Research output: Contribution to journalArticle

Kirton, O, Civetta, J, Hudson-Civena, J, Gomez, E, Shatz, DV, McKenney, M, Byers, P, Ginzburg, E, Augenstein, J, Sleeman, O & Dehaven, B 1998, 'Gastric intramucosal pH (phî) driven resuscitation and antioxidants: normalized phi is associated with high survival', Critical Care Medicine, vol. 26, no. 1 SUPPL..
Kirton, O. ; Civetta, J. ; Hudson-Civena, J. ; Gomez, E. ; Shatz, David V ; McKenney, M. ; Byers, P. ; Ginzburg, E. ; Augenstein, J. ; Sleeman, O. ; Dehaven, B. / Gastric intramucosal pH (phî) driven resuscitation and antioxidants : normalized phi is associated with high survival. In: Critical Care Medicine. 1998 ; Vol. 26, No. 1 SUPPL.
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abstract = "Introduction: Low mucosal lonoroetric pH has been shown to be highly predictive of mortality in general and trauma ICU patients. Methods: Prospective 3 month study of critically injured blunt and penetrating admissions to a Level 1 Trauma ICU. Hemodynamk optimization was based on achieving pHi > 7.25, including the use of splanchnic-sparing vasopressors (e.g., dobutamine, dopamine, etc.). All patients received intravenous doses of mannitol, folate, Iklocaine, vitamin C. selenium, polymyxin B and hydrocortisone, [n addition. Vitamin A and E phis glutamine and N-acetylcysteine were given by enterai route. If pHi became abnormal (Abn-pHi <725) post-normalization (Nonn-pHi;>7.25), the episode(s) was characterized as a fluctuation (Flue). Data was analyzed by Cht-square. Results: 92 patients : (mearttSD) Trauma Score -14±2, ISS- 2716; CCS -13±3; APACHE II- I9±8. pHi Group Lived Died {\%} Lived Cfci-Sq TVn.lPt. Q->A f. QjH EadNonn 87 84 3 97{\%} g-H Ah 5 2 3 Start Abo 16 12 4 75V. St.rt Nnrm 76 74 > Always Nora 58 58 0 100{\%} Always Aba 2 1 1 50{\%} Ab_->nM-Norai 29 26 3 90{\%} isiii->irii_2 2 2 054 < AbaAaytime 34 28 6 82{\%} End Aba 523 40{\%} End Norm 29 26 3 90{\%} < .0399 14 of 16 abnormal pHi (88{\%}) on admission normalized with the protocol. In this subset, overall mortality of normalized pHi was 3{\%} (p<.001), compared to a 60{\%} mortality in those patients with uncorrectable pHi (p<.001). Conclosion: Normalization of pHi using a pHi-driven protocol and administering agents to prevent and scavenge oxygen free-radicals in the critically-ill injured is associated with high survival.",
author = "O. Kirton and J. Civetta and J. Hudson-Civena and E. Gomez and Shatz, {David V} and M. McKenney and P. Byers and E. Ginzburg and J. Augenstein and O. Sleeman and B. Dehaven",
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T1 - Gastric intramucosal pH (phî) driven resuscitation and antioxidants

T2 - normalized phi is associated with high survival

AU - Kirton, O.

AU - Civetta, J.

AU - Hudson-Civena, J.

AU - Gomez, E.

AU - Shatz, David V

AU - McKenney, M.

AU - Byers, P.

AU - Ginzburg, E.

AU - Augenstein, J.

AU - Sleeman, O.

AU - Dehaven, B.

PY - 1998

Y1 - 1998

N2 - Introduction: Low mucosal lonoroetric pH has been shown to be highly predictive of mortality in general and trauma ICU patients. Methods: Prospective 3 month study of critically injured blunt and penetrating admissions to a Level 1 Trauma ICU. Hemodynamk optimization was based on achieving pHi > 7.25, including the use of splanchnic-sparing vasopressors (e.g., dobutamine, dopamine, etc.). All patients received intravenous doses of mannitol, folate, Iklocaine, vitamin C. selenium, polymyxin B and hydrocortisone, [n addition. Vitamin A and E phis glutamine and N-acetylcysteine were given by enterai route. If pHi became abnormal (Abn-pHi <725) post-normalization (Nonn-pHi;>7.25), the episode(s) was characterized as a fluctuation (Flue). Data was analyzed by Cht-square. Results: 92 patients : (mearttSD) Trauma Score -14±2, ISS- 2716; CCS -13±3; APACHE II- I9±8. pHi Group Lived Died % Lived Cfci-Sq TVn.lPt. Q->A f. QjH EadNonn 87 84 3 97% g-H Ah 5 2 3 Start Abo 16 12 4 75V. St.rt Nnrm 76 74 > Always Nora 58 58 0 100% Always Aba 2 1 1 50% Ab_->nM-Norai 29 26 3 90% isiii->irii_2 2 2 054 < AbaAaytime 34 28 6 82% End Aba 523 40% End Norm 29 26 3 90% < .0399 14 of 16 abnormal pHi (88%) on admission normalized with the protocol. In this subset, overall mortality of normalized pHi was 3% (p<.001), compared to a 60% mortality in those patients with uncorrectable pHi (p<.001). Conclosion: Normalization of pHi using a pHi-driven protocol and administering agents to prevent and scavenge oxygen free-radicals in the critically-ill injured is associated with high survival.

AB - Introduction: Low mucosal lonoroetric pH has been shown to be highly predictive of mortality in general and trauma ICU patients. Methods: Prospective 3 month study of critically injured blunt and penetrating admissions to a Level 1 Trauma ICU. Hemodynamk optimization was based on achieving pHi > 7.25, including the use of splanchnic-sparing vasopressors (e.g., dobutamine, dopamine, etc.). All patients received intravenous doses of mannitol, folate, Iklocaine, vitamin C. selenium, polymyxin B and hydrocortisone, [n addition. Vitamin A and E phis glutamine and N-acetylcysteine were given by enterai route. If pHi became abnormal (Abn-pHi <725) post-normalization (Nonn-pHi;>7.25), the episode(s) was characterized as a fluctuation (Flue). Data was analyzed by Cht-square. Results: 92 patients : (mearttSD) Trauma Score -14±2, ISS- 2716; CCS -13±3; APACHE II- I9±8. pHi Group Lived Died % Lived Cfci-Sq TVn.lPt. Q->A f. QjH EadNonn 87 84 3 97% g-H Ah 5 2 3 Start Abo 16 12 4 75V. St.rt Nnrm 76 74 > Always Nora 58 58 0 100% Always Aba 2 1 1 50% Ab_->nM-Norai 29 26 3 90% isiii->irii_2 2 2 054 < AbaAaytime 34 28 6 82% End Aba 523 40% End Norm 29 26 3 90% < .0399 14 of 16 abnormal pHi (88%) on admission normalized with the protocol. In this subset, overall mortality of normalized pHi was 3% (p<.001), compared to a 60% mortality in those patients with uncorrectable pHi (p<.001). Conclosion: Normalization of pHi using a pHi-driven protocol and administering agents to prevent and scavenge oxygen free-radicals in the critically-ill injured is associated with high survival.

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