Gastric mucosal hemodynamics after thermal or head injury. A clinical application of reflectance spectrophotometry.

In order to elucidate the role of mucosal blood flow in stress ulceration in critically ill patients with thermal or head injury, we applied reflectance spectrophotometry to the human gastric mucosa. During gastrofiberscopy, the spectra of the corpus and antral gastric mucosa were taken using a flexible coaxial optic bundle and a computer-equipped spectrophotometer. The subjects were 27 patients with thermal or head injury, and they were compared with 8 young healthy volunteers and 9 age-matched patients who had GI symptoms but showed no gastric lesion endoscopically. In 8 patients whose gastric mucosal blood volume at the time of admission decreased to about 27% of the level of young healthy volunteers or 36% of that of age-matched controls, the acute gastric mucosal lesions appeared in the corpus mucosa mostly within a few days after the measurement of mucosal blood volume. In contrast, in cases with thermal or head injury and without acute gastric mucosal lesions, the mucosal blood volume did not decrease significantly as compared with that of the young healthy volunteers and age-matched controls. In conclusion, analysis of mucosal has revealed that ischemia in the gastric mucosa is the main cause of the acute gastric mucosal lesions in patients with thermal or head injury. Further, this study represented noninvasive methodology for the measurement of the gastric mucosal blood volume in patients with gastric diseases.