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[Gastric tonometry as monitoring system in abdominal surgery]
V Rollán Villamarín1, J Casado Flores, M Monleón Luque
1Servicio de Cirugía Pediátrica, Hospital del Niño Jesús, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid.
Insights
Intramucosal pH (pHi) significantly decreases during pediatric abdominal surgery but recovers within 16 hours post-operation. This study tracked pHi changes in young patients undergoing lengthy abdominal procedures.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Physiology
Background:
- Intramucosal pH (pHi) monitoring is crucial for assessing tissue oxygenation and perfusion.
- Understanding pHi dynamics during surgery is vital for optimizing patient outcomes in pediatric abdominal surgery.
Purpose of the Study:
- To investigate the changes in intramucosal pH (pHi) during and immediately after prolonged abdominal surgery in pediatric patients.
- To analyze the recovery pattern of pHi in the postoperative period.
Main Methods:
- A prospective study involving 25 pediatric patients undergoing intra-abdominal surgery (mean age 5.6 years, operative time >90 minutes).
- Intramucosal pH (pHi) was measured hourly during surgery and every 8 hours postoperatively using a gastric sigmoid tonometer.
- A total of 157 pHi measurements were recorded.
Main Results:
- Intramucosal pH (pHi) showed a significant decrease from 7.36 preoperatively to 7.22 during the operative period.
- Postoperatively, pHi levels increased, reaching 7.36 within 24 hours.
- The observed changes in pHi were statistically significant (p < 0.005).
Conclusions:
- Pediatric abdominal surgery leads to a significant reduction in intramucosal pH (pHi).
- Intramucosal pH (pHi) demonstrates a notable recovery within 16 hours after the surgical procedure.
- These findings highlight the physiological response to surgical stress and the subsequent recovery of tissue perfusion.
Objective:
The aim of this study is the evolution of the intramucosal pH (pHi) during the quirurgic and the immediate postoperative process in pediatric patients, operated in abdominal surgery longer than 90 minutes.
Material And Methods:
A prospective study including 25 patients was done. In all of them intraabdominal surgery was performed. The mean age was 5.6 +/- 3 years, range from 9 months to 13 years. The operative time was 207 +/- 76 minutes. The pHi was measured by means of a sigmoid tonometer introduced in the stomach. A tonometry was done hourly during the operative procedure, and every 8 hours during the postoperative period.
Results:
157 determinations of pHi were made with an average of 6.28 per patient. During the operative period the pHi decreased from 7.36 +/- 0.11 (30') to 7.22 +/- 0.11 (210'). During the postoperative, the pHi increased to 7.36 +/- 0.05, 24 hours later (p < 0.005).
Conclusions:
During the surgery there was a significant reduction of the pHi, which recovered 16 hours after in the postoperative.