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Gastric alkalinization after major trauma.

Christine S Cocanour1, Elizabeth D Dial, Lenard M Lichtenberger

  • 1Department of Surgery, UC Davis Medical Center, Sacramento, California, USA. christine.cocanour@ucdmc.ucdavis.edu

The Journal of Trauma
|March 12, 2008
PubMed
Summary
This summary is machine-generated.

Trauma patients often develop an alkaline gastric environment, potentially due to bile reflux. This study monitored gastric pH in trauma patients, finding alkalinization in most during the initial days post-injury.

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Area of Science:

  • Gastroenterology
  • Trauma Medicine
  • Critical Care

Background:

  • Gastric function in trauma patients is not well understood.
  • Animal models suggest shock leads to gastric alkalinization and bile reflux.
  • Previous studies indicated gastric alkalization in trauma patients even without acid-suppressing medications.

Purpose of the Study:

  • To investigate the hypothesis that trauma patients exhibit an alkaline gastric environment, possibly due to bile reflux.
  • To continuously monitor gastric pH in major torso trauma patients receiving standardized shock resuscitation.

Main Methods:

  • A prospective observational study was conducted at an urban Level I trauma center.
  • Twelve eligible major torso trauma patients (excluding severe head injuries) underwent continuous gastric pH monitoring for 7 days.
  • Gastric samples were collected daily to assay for total bile acids and pH; no stress gastritis prophylaxis was administered.

Main Results:

  • Nine out of twelve patients initially presented with a gastric pH >4, indicating alkalinization.
  • Gastric pH levels decreased over time, with most of the day spent at pH <4 by day 4.
  • While bile acids were present in all patients, no significant correlation was found between gastric pH and bile acid concentration.

Conclusions:

  • Traumatic injury induces gastric luminal alkalinization in patients.
  • Bile acid reflux may contribute to this alkalinization, but likely only partially.
  • Further research is needed to identify other factors responsible for gastric alkalinization in trauma.