| Changes in gastric intramucosal pH following mesenteric traction in patients undergoing pancreas surgery. | |
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MedLine Citation:
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PMID: 10207237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIM: During major abdominal surgery, mesenteric traction (MT) may result in hemodynamic instability mainly due to endogenous prostacyclin release. Gastric intramucosal pH (pHi) and PiCO2 are indicators of splanchnic tissue perfusion with a predictive value for the postoperative outcome. We investigated the influence of MT on gastric pHi and on postoperative outcome in patients undergoing pancreas surgery. METHODS: Forty-six consecutive patients scheduled for pancreas surgery were investigated. We registered hemodynamics and pHi by gastric tonometry and documented postoperative outcome (complications, hospital stay). Baseline data (T0) were recorded after skin incision. Further assessments followed 30, 60 and 120 min after intentional MT (T1-3) and at the end of surgery (T4). RESULTS: Thirty-three patients demonstrated a decrease in mean arterial pressure (MAP) following MT, whereas 13 patients showed entirely stable hemodynamics. The significant reduction in MAP in patients with an MT response was not associated with changes in pHi as compared to patients with no response (stable MAP) (T0 7.34 +/- 0.08 vs. 7.35 +/- 0.06; T1 7.34 +/- 0.05 vs. 7.32 +/- 0.07; T2 7.32 +/- 0. 05 vs. 7.31 +/- 0.08; T3 7.32 +/- 0.05 vs. 7.32 +/- 0.07; T4 7.26 +/- 0.1 vs. 7.27 +/- 0.08; mean +/- SD, MT response vs. no response). Neither MT response nor gastric intramucosal acidosis as evidenced by a pHi <7.32 at the end of surgery predicted postoperative complications or longer hospital stay. CONCLUSION: No deterioration of gastric pHi was found, which could reflect acceptable splanchnic perfusion and oxygenation despite systemic blood pressure reactions in patients experiencing an MT response. |
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Authors:
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A Brinkmann; W Seeling; M Rockemann; J H Junge; P Radermacher; H Wiedeck; M W Büchler; M Georgieff |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Digestive surgery Volume: 16 ISSN: 0253-4886 ISO Abbreviation: Dig Surg Publication Date: 1999 |
Date Detail:
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Created Date: 1999-07-22 Completed Date: 1999-07-22 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8501808 Medline TA: Dig Surg Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 117-24 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University Clinics, Ulm, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Female Follow-Up Studies Gastric Mucosa / secretion* Hemodynamics / physiology Humans Hydrogen-Ion Concentration* Intraoperative Complications / diagnosis* Male Mesentery / blood supply*, surgery Middle Aged Monitoring, Intraoperative Pancreatectomy / adverse effects*, methods Pancreatic Diseases / surgery* Predictive Value of Tests Traction Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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