Document Detail

Comparison of clinical information gained from routine blood-gas analysis and from gastric tonometry for intramural pH.
MedLine Citation:
PMID:  8093745     Owner:  NLM     Status:  MEDLINE    
The measurement of gastric intramucosal pH (pHi) has been advocated to assist in decision-making for critically ill patients. To assess whether the information obtained from the measurement of pHi can be obtained from other measurements of metabolic acidosis, we studied 20 consecutive patients admitted to the intensive care unit. A mean of eight (range two to fourteen) data sets per patient were obtained, comprising measurement of arterial pH, pO2, pCO2, and oxygen saturation, tonometer balloon fluid pCO2, arterial pressures, and cardiac output. Bicarbonate concentration, base deficit or excess in blood and extracellular fluid, and pHi were calculated from these measurements. Relations between the variables and pHi were assessed by within-subject correlation comparisons. There were significant correlations (r > 0.6, p < 0.001) between markers of metabolic acidosis (base deficit in blood and extracellular fluid and bicarbonate concentration) and pHi. A blood base deficit of -4.65 or less and an extracellular-fluid base deficit of -6.13 or less could estimate pHi below 7.32 (lower limit of normal range) with sensitivity of at least 77% and specificity of at least 96%. There was no patient in whom either pHi or blood base deficit consistently reflected acidosis when the other variable did not. We conclude that the information that is obtained by gastric tonometry for pHi can be obtained more simply from measurements of metabolic acidosis; these variables can be calculated from routinely available blood-gas measurements.
O Boyd; C J Mackay; G Lamb; J M Bland; R M Grounds; E D Bennett
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Lancet     Volume:  341     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-02-19     Completed Date:  1993-02-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  142-6     Citation Subset:  AIM; IM    
General Intensive Care Unit, St George's Hospital, London, UK.
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MeSH Terms
Acidosis / diagnosis*
Blood Gas Analysis*
Gastric Acidity Determination*
Hydrogen-Ion Concentration
Middle Aged
Comment In:
Lancet. 1993 Mar 13;341(8846):692   [PMID:  8095595 ]
Lancet. 1993 Mar 13;341(8846):691-2   [PMID:  8095594 ]
Lancet. 1993 Mar 13;341(8846):692-3   [PMID:  8095596 ]

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