[The effect of normothermic and hypothermic gastric irrigation on blood flow of the canine stomach (author's transl)].

A gastric irrigation by an open naso-gastric tube with ice-solutions is a standard procedure in the management of upper gastrointestinal bleeding. In 6 dogs the effect of an increased intragastric pressure and of gastric cooling upon gastric blood flow was examined, using radioactive microspheres. Filling the stomach with saline solution of 38 degrees C to an intragastric pressure of 15 cm H2O reduces canine gastric blood flow from 21,3 +/- 4,4 ml X 100 g-1 X min-1 to 12,6 +/- 2,9 ml significantly. Probably as a consequence of compression only mucosal blood flow is lowered. Blood flow during local hypothermia (21 degrees C at the outer wall of the stomach) at the same intragastric pressure is 60% less than the control value at empty stomach and 33% less than the value at increased pressure without lowered temperature (p less than 0,01). Blood flow to the muscularis is now reduced too. This may be explained by vasoconstriction. However, local hypothermia causes the stomach wall bleeding time to increase three times (13), whereas irrigation by 38 degrees C fluid doesn't alter the coagulation of blood. An irrigation with high volumes of a fluid with body-temperature, which lowers gastric blood flow without changing coagulation and with an open system, which allows the cleaning of the stomach, seems to be more valuable than local hypothermia by a ballon system.