| Gastric tonometry: a new monitoring modality in the intensive care unit. | |
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MedLine Citation:
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PMID: 10155169 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In many critically ill patients, systemic measures of hemodynamic and O2 transport variables may not be sufficiently sensitive to portray the complex interaction between energy requirements and energy supply in all tissues. Gastric or intestinal tonometry has been proposed as a relative noninvasive index of the adequacy of aerobic metabolism in the gut mucosa, a tissue that is particularly vulnerable to alterations in perfusion and oxygenation. The gut mucosa lacks some of the microvascular control mechanisms that allow other tissues, such as the heart, skeletal muscle, and the brain, to increase tissue perfusion during times of stress, and, just like the canary, it will display metabolic changes indicative of dysoxia earlier than those more "vital" tissues. The tonometric measurement of mucosal PCO2 rests on the premise that equilibrium exists between mucosal and luminal PCO2. Increases in mucosal PCO2, or conversely, decreases in mucosal pH (pHi), are associated with the development of intestinal mucosa ischemia. The clinical utility of pHi to detect intestinal mucosal ischemia has been demonstrated in patients undergoing abdominal aortic surgery. Further, a low gastric mucosal pHi on admission to the ICU appears to be predictive of mortality and pHi-guided resuscitation may improve outcome in a subpopulation of patients admitted to the ICU with normal pHi, perhaps by preventing splanchnic ischemia and the development of a systemic oxygen deficit. |
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Authors:
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G Gutierrez; S D Brown |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of intensive care medicine Volume: 10 ISSN: 0885-0666 ISO Abbreviation: J Intensive Care Med Publication Date: 1995 Jan-Feb |
Date Detail:
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Created Date: 1995-11-01 Completed Date: 1995-11-01 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8610344 Medline TA: J Intensive Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 34-44 Citation Subset: T |
Affiliation:
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Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center at Houston 77030, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aerobiosis Anaerobiosis Carbon Dioxide / metabolism Critical Illness* / mortality Gastric Mucosa / blood supply, metabolism* Humans Hydrogen-Ion Concentration Ischemia / metabolism Manometry / methods Partial Pressure Prognosis Splanchnic Circulation |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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