• Intensive care medicine · Jan 1994

    Low intramucosal pH is associated with failure to acidify the gastric lumen in response to pentagastrin.

    • D Higgins, M G Mythen, and A R Webb.
    • Bloomsbury Institute of Intensive Care Medicine, Middlesex Hospital, London, UK.
    • Intensive Care Med. 1994 Jan 1; 20 (2): 105-8.

    ObjectiveTo determine if low gastric intramucosal pH is associated with impaired secretion of gastric acid after pentagastrin stimulation.DesignProspective study.SettingIntensive care unit of a university teaching hospital.Patients20 patients requiring mechanical ventilation.InterventionsAll patients with a gastric luminal pH > 4 were given pentagastrin 6 micrograms/kg s.c. to stimulate gastric acid secretion and the response assessed by further measurements of gastric luminal pH.Measurements And ResultsGastric intramucosal pH (pHi) and luminal pH (pHL) were measured. Patients were divided into two groups on the basis of a low or normal pHi (A value of 7.35 was taken as the lower limit of normal). Patients (n = 6) with normal pHi (7.40 +/- 0.05 [mean +/- SD]) and a luminal pH > 4 (5.65 +/- 1.25) all had a decrease in pHL in response to pentagastrin (decrease in pHL 4.02 +/- 1.52). Of the patients (n = 7) with low pHi (7.2 +/- 0.13) and a pHL > 4 (6.51 +/- 0.48) only one responded to pentagastrin (decrease in pHL for this group 0.93 +/- 1.86). Patients with a pHL < 4 (2.4 +/- 0.71) were not given pentagastrin (n = 7).ConclusionSome critically ill patients with low gastric intramucosal pH appear to have an impaired ability to acidify the gastric lumen in response to pentagastrin.

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