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Related Experiment Videos

Gastric tonometry: precision and reliability are improved by a phosphate buffered solution

G Knichwitz1, M Kuhmann, G Brodner

  • 1Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Westfälische Wilhelms-Universität, Münster, Germany.

Critical Care Medicine
|March 1, 1996
PubMed
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Phosphate buffered solution improves accuracy in gastric tonometry compared to normal saline. This enhances reliable intramucosal pH measurement in critical care patients.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Medical Technology

Background:

  • Intramucosal PCO2 measurement is crucial for assessing tissue perfusion in critically ill patients.
  • Normal saline is commonly used as tonometric fluid but may introduce inaccuracies.
  • Phosphate buffered solution is a potential alternative tonometric fluid.

Purpose of the Study:

  • To compare phosphate buffered solution with normal saline as tonometric fluid for intramucosal PCO2 measurement.
  • To evaluate the impact of different tonometric fluids on blood gas analyzer performance.

Main Methods:

  • Prospective, unblinded comparison in six septic patients in a postsurgical critical care unit.
  • Two tonometric probes were placed in the gastric lumen; one with saline, the other with phosphate buffered solution.

Related Experiment Videos

  • PCO2 measurements were analyzed using three different blood gas analyzers.

    • Main Results:

    • Significant instrumental bias in PCO2 analysis was observed with normal saline across different blood gas analyzers.
    • Phosphate buffered solution demonstrated improved consistency and reduced variance in PCO2 measurements.
    • Coefficients of determination indicated better inter-instrument agreement with phosphate buffered solution.

    Conclusions:

    • Normal saline as tonometric fluid introduces considerable instrumental bias, hindering reliable intramucosal pH determination.
    • Phosphate buffered solution enhances the accuracy and reliability of intramucosal pH measurements in vivo.
    • Utilizing phosphate buffered solution is recommended for more precise gastric tonometry.