OBJECTIVE: To investigate whether gastric intramucosal acidosis is associated with a decreased gastric mucosal blood flow in mechanically ventilated patients. DESIGN: Prospective, clinical investigation. SETTING: University hospital intensive care unit. PATIENTS: Seventeen mechanically ventilated patients with stable hemodynamic status. INTERVENTIONS: Gastric tonometry and endoscopic assessment of mucosal blood flow. MEASUREMENTS AND MAIN RESULTS: Six patients had gastric intramucosal acidosis (intramucosal pH [pHi] of 7.24 +/- 0.06), whereas the remaining 11 patients had pHi values within the normal range (7.44 +/- 0.01). No differences were found between intramucosal acidotic and nonacidotic patients with respect to their general and hemodynamic characteristics. Patients with intramucosal acidosis had a lower gastric mucosal blood flow, as assessed by laser-Doppler flowmetry, than nonacidotic patients (1.4 +/- 0.1 vs. 2.1 +/- 0.2 volts, respectively; p < .05). Reflectance spectrophotometry disclosed that patients with low gastric pHi had also a significantly (p < .05) lower hemoglobin content index (61 +/- 4 arbitrary units) than patients with normal pHi (81 +/- 3 arbitrary units), whereas oxygen saturation index was similar for both groups. CONCLUSION: Our results support the hypothesis that gastric mucosal hypoperfusion underlies the development of intramucosal acidosis in mechanically ventilated patients.
OBJECTIVE: To investigate whether gastric intramucosal acidosis is associated with a decreased gastric mucosal blood flow in mechanically ventilated patients. DESIGN: Prospective, clinical investigation. SETTING: University hospital intensive care unit. PATIENTS: Seventeen mechanically ventilated patients with stable hemodynamic status. INTERVENTIONS: Gastric tonometry and endoscopic assessment of mucosal blood flow. MEASUREMENTS AND MAIN RESULTS: Six patients had gastric intramucosal acidosis (intramucosal pH [pHi] of 7.24 +/- 0.06), whereas the remaining 11 patients had pHi values within the normal range (7.44 +/- 0.01). No differences were found between intramucosal acidotic and nonacidotic patients with respect to their general and hemodynamic characteristics. Patients with intramucosal acidosis had a lower gastric mucosal blood flow, as assessed by laser-Doppler flowmetry, than nonacidotic patients (1.4 +/- 0.1 vs. 2.1 +/- 0.2 volts, respectively; p < .05). Reflectance spectrophotometry disclosed that patients with low gastric pHi had also a significantly (p < .05) lower hemoglobin content index (61 +/- 4 arbitrary units) than patients with normal pHi (81 +/- 3 arbitrary units), whereas oxygen saturation index was similar for both groups. CONCLUSION: Our results support the hypothesis that gastric mucosal hypoperfusion underlies the development of intramucosal acidosis in mechanically ventilated patients.
Authors: Jacques Creteur; Daniel De Backer; Yasser Sakr; Marc Koch; Jean-Louis Vincent Journal: Intensive Care Med Date: 2006-02-17 Impact factor: 17.440
Authors: Gustavo A Ospina-Tascón; Diego F Bautista-Rincón; Mauricio Umaña; José D Tafur; Alejandro Gutiérrez; Alberto F García; William Bermúdez; Marcela Granados; César Arango-Dávila; Glenn Hernández Journal: Crit Care Date: 2013-12-13 Impact factor: 9.097