Elizalde JI, Hernández C, Llach J, Montón C, Bordas JM, Piqué JM, Torres A. Gastric intramucosal acidosis in mechanically ventilated patients: role of mucosal blood flow.
Crit Care Med 1998;
26:827-32. [PMID:
9590311 DOI:
10.1097/00003246-199805000-00011]
[Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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