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Gastric tonometry in multiple trauma patients

R M Roumen1, J P Vreugde, R J Goris

  • 1Department of Surgery, University Hospital Nijmegen, The Netherlands.

The Journal of Trauma
|March 1, 1994
PubMed
Summary
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Gastric intramucosal pH (pHi) monitoring in trauma patients may indicate complications. Low pHi levels were observed in patients who developed major complications or died, suggesting its utility in intensive care units.

Area of Science:

  • Critical Care Medicine
  • Trauma Surgery
  • Gastroenterology

Background:

  • Splanchnic ischemia and intestinal mucosal damage are common post-severe trauma.
  • Gastric intramucosal pH (pHi) indirectly assesses mucosal oxygenation adequacy.

Purpose of the Study:

  • To prospectively examine posttraumatic gastric pHi values in multiple trauma patients.
  • To determine the correlation between pHi and patient outcomes.

Main Methods:

  • Gastric pHi was measured using a tonometer via nasogastric route in 15 trauma patients.
  • A pHi value ≤ 7.32 was defined as low.

Main Results:

  • Eight patients exhibited low pHi values post-trauma; three developed major complications (two ARDS), and two died.

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  • Seven patients with consistently normal pHi levels recovered without complications.
  • No correlation found between initial pHi and ISS, shock, lactic acidosis, or APACHE II scores.

    • Conclusions:

    • Monitoring gastric pHi is useful for identifying severely injured patients at risk in the ICU.
    • Low pHi levels may predict major complications and mortality in trauma patients.