Prognostic value of gastric intramural pH in surgical intensive care patients

Gastric Tonometry as a Prognostic Index of Mortality in Sepsis

“…A large difference in the partial pressure of carbon dioxide between gastric mucosa and arterial blood (PgCO 2 -PaCO 2 ) has been shown to be more specific indicator of splanchnic ischemia and predictors of outcome [15,16]. Our study is in agreement with these findings.…”

Gastric hypercarbia and adverse outcome after cardiac surgery

“…This observation is not surprising since it is known that many patients can (and do) recover from transient insults. It is also interesting to note that despite many potential "pitfalls" related to gastric tonometry [8] most studies show that it is predictive of adverse outcome [7,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. For example, several patients in our study had a "negative" CO 2 gap, which is not likely to be physiological.…”

“…Although we also examined potential associations with hemodynamic variables, our study was not designed rigorously to prove that gastric PCO 2 measurements are associated with adverse outcome independent of these other parameters. Enrollment of approximately 40 subjects was predicted to be adequate based on positive results from numerous similar studies using a similar number of subjects, for example, 12 [13], 14 [17], 24 [12], 42 [22], 48 [24], and 59 [15].…”

“…Confusion associated with use of restraints Coma or new persistent postoperative deficit or 1:1 nursing, confusion requiring assistance (>24 h) deficit b with feeding, toilet use, or transient ischemic attack (duration <24 h), or general seizure in last 24 h b Generalized weakness Weakness associated with inability to walk Inability to walk more than 10 ft even more than 100 ft without stopping with with assistance with person or walker c or without assistance c Wound complication Wound dehiscence or pus associated with bedside Wound dehiscence or presence of pus associated intervention (e.g., partial opening) or starting with return to the operating room for exploration, of antibiotics within 72 h repair, or débridement within 72 h Hematological Requirement for any of the following Bleeding/oozing from insertion site(s) within the last 24 h: donor erythrocytes, platelets, of intravascular catheter(s) or administration fresh frozen plasma, or cryoprecipitate in the absence of more than 4 U donor erythrocytes of surgical source of bleeding within the last 24 h in the absence of surgical source of bleeding Pain Surgical wound pain significant enough Surgical wound pain significant enough to require intravenous opioids to require regional analgesia a Sepsis defined as two or more of the following: (a) temperature higher than 38°C or lower than 36°C, (b) heart rate higher than 90 bpm, (c) respiratory rate higher than 20 breaths per minute or PaCO 2 <32 mmHg, (d) white blood cell count higher than 12 or lower than 4 or more than 10% immature band forms b Neurological: assign 0 points if patient is sedated/paralyzed and last assessment was normal c Weakness: assign 0 points if patient unable to leave bed do to physician's orders or is on a ventilator [7,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Most of these studies, however, focused on the measurement termed pHi, which takes into account both metabolic acidosis and gastric hypercabia.…”

Intramucosal pH and Tissue Oxygenation during Splanchnic Ischaemia

“…Tonometry permits assessment of intestinal tissue oxygenation and may serve as an early marker of impaired mucosal oxygenation [ 5]. This method has been used for basic research [4][5][6][7][8][9][10][11] and for clinical studies [12][13][14][15][16][17][18][19].…”