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Gastric intramural pH in mechanically ventilated patients
Z Mohsenifar1, J Collier, S K Koerner
1Department of Medicine, UCLA School of Medicine 90048, USA.
Thorax
|June 1, 1996
Summary
Gastric intramural pH (pHi) accurately predicts patient outcomes in mechanically ventilated individuals. A low gastric pHi, indicating gastrointestinal ischemia, is a strong predictor of mortality, even with normal hemodynamics.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Physiology
Background:
- Assessing patient outcomes in mechanical ventilation is crucial.
- Hemodynamic stability does not always correlate with patient prognosis.
- Gastric intramural pH (pHi) is a potential, yet underutilized, prognostic marker.
Purpose of the Study:
- To test the hypothesis that gastric intramural pH (pHi) predicts outcome in hemodynamically stable, mechanically ventilated patients.
- To evaluate gastric pHi as a prognostic indicator compared to existing parameters.
Main Methods:
- Collected simultaneous arterial blood and gastric juice samples from 25 mechanically ventilated patients.
- Calculated gastric pHi using the provided formula.
- Monitored patient outcomes (survival or death) within 45 days.
Main Results:
- Gastric pHi was a superior predictor of outcome compared to all other utilized parameters.
- Patients with normal arterial pH but gastric pHi < 7.25 had a 66% mortality rate.
- Gastric pHi < 7.25 demonstrated 86% sensitivity and 83% specificity for predicting death.
Conclusions:
- Low gastric pHi, a marker of gastrointestinal ischemia, can occur despite normal hemodynamics.
- Gastric pHi is an accurate predictor of illness severity and mortality in mechanically ventilated patients.
- This finding highlights the importance of monitoring gastric pHi for improved patient management.