• J I Elizalde, C Hernández, J Llach, C Montón, J M Bordas, J M Piqué, and A Torres.
• Serveis de Gastroenterologia, Departament de Medicina, Hospital Clínic, Universitat de Barcelona, Spain.
• Crit. Care Med. 1998 May 1; 26 (5): 827-32.

ObjectiveTo investigate whether gastric intramucosal acidosis is associated with a decreased gastric mucosal blood flow in mechanically ventilated patients.DesignProspective, clinical investigation.SettingUniversity hospital intensive care unit.PatientsSeventeen mechanically ventilated patients with stable hemodynamic status.InterventionsGastric tonometry and endoscopic assessment of mucosal blood flow.Measurements And Main ResultsSix 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.ConclusionOur results support the hypothesis that gastric mucosal hypoperfusion underlies the development of intramucosal acidosis in mechanically ventilated patients.

22 keywords...

hide…