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Relationship between ventilator-associated pneumonia and intramucosal gastric pHi: a case-control study
C Hernández1, M el-Ebiary, J Gonzalez
1Department de Medicina, Hospital Clínic, Universitat de Barcelona, Spain.
Journal of Critical Care
|September 1, 1996
Summary
Low intramucosal gastric pH (pHi) was not common in patients with nosocomial pneumonia but was linked to higher mortality. This study explored the relationship between gastric pH and pneumonia outcomes.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Infectious Diseases
Background:
- Nosocomial pneumonia is a significant concern in intensive care units.
- Intramucosal gastric pH (pHi) has been proposed as a marker for bacterial translocation, potentially linking to pneumonia development.
Purpose of the Study:
- To assess the relationship between nosocomial pneumonia, intramucosal gastric pH (pHi), and patient outcomes in an ICU setting.
- To investigate pHi as a potential indicator in the context of nosocomial infections.
Main Methods:
- Studied 33 ICU patients (18 with pneumonia, 15 without) hospitalized >72 hours.
- Measured intramucosal gastric pH (pHi), arterial pH (pHa), and tonometer PtCO2.
- Utilized quantitative cultures of pharyngeal swabs, gastric lumen, and protected specimen brush for bacterial analysis.
Main Results:
- While most pneumonia patients did not exhibit low pHi (<7.32), those with pneumonia had significantly higher gastric lumen pH.
- Low pHi (<7.32) was observed exclusively in patients with pneumonia (P = .04).
- Nonsurvivors showed more acidic pHi (7.33 +/- 0.11) compared to survivors (7.44 +/- 0.06; P = .045).
Conclusions:
- Intramucosal gastric acidosis (low pHi) is not a universal finding in nosocomial pneumonia.
- However, a low pHi is significantly associated with increased mortality in these patients.