[Assessing the pH value of gastric mucosa with tonometry--general practice and potential clinical value]

The significance of the gastrointestinal region in the genesis and course of sepsis makes the monitoring of this region a fundamental importance in critical ill patients. The low-invasive assessment of gastric mucosal pH (pHi) seems to be able to detect a disturbed tissue oxygenation in the splanchnic region at an early stage. Animal studies have shown that there is a good correlation between pHi and directly measured pH. Splanchnic tissue hypoxia, induced in an experimental setting, is detectable by the pHi method. It has been shown in clinical studies that the patients' outcome depends on the first pHi, measured on admission to the ICU. An initial study has shown that patients with a pHi in the normal range on admission to the ICU had a better outcome if they were treated by a pHi-value orientated therapy. Nevertheless, some questions remain: There are problems with the practical use of this method, and it is unclear whether the pHi is really a marker for the whole splanchnic area. Further studies are required to determine the status of pHi in the clinical setting.