El pH intramucoso gástrico como índice terapéutico de oxigenación tisular en pacientes en estado crítico
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Updated: Jun 18, 2026
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In Vivo EPR Assessment of pH, pO2, Redox Status, and Concentrations of Phosphate and Glutathione in the Tumor Microenvironment
Published on: March 16, 2018
G Gutierrez1, F Palizas, G Doglio
1Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston 77030.
Lancet (London, England)
|January 25, 1992
Resumen
La monitorización del pH intramucoso gástrico (pHi) de la terapia guiada mejoró la supervivencia en la unidad de cuidados intensivos (UCI) de pacientes con pHi inicial normal. Este enfoque puede prevenir la hipoxia de órganos y mejorar los resultados de los pacientes.
Área de la Ciencia:
- Medicina de cuidados críticos Medicina de cuidados críticos.
- Gastroenterología y Gastroenterología.
- Fisiología Fisiología Fisiología.
Sus antecedentes:
- Las caídas en el pH intramucoso gástrico (pHi) se correlacionan con un aumento de la morbilidad y la mortalidad en pacientes de la unidad de cuidados intensivos (UCI).
- El mantenimiento de una perfusión esplancánica adecuada es crucial para los resultados de los pacientes de UCI.
Objetivo del estudio:
- Para probar si los resultados de la unidad de cuidados intensivos (UCI) pueden mejorarse mediante una terapia guiada por cambios en el pH intramucoso gástrico (pHi).
- Evaluar si la optimización de la disponibilidad sistémica de oxígeno a través de la terapia guiada por pHi mejora la supervivencia del paciente.
Principales métodos:
- Un ensayo controlado aleatorizado en el que participaron 260 pacientes de UCI con puntuaciones APACHE II de 15-25.
- Los pacientes fueron asignados a la atención estándar o a un grupo de protocolo que recibió terapia para mejorar el transporte de oxígeno o reducir la demanda cuando el pHi cayó por debajo de 7.35.
- Tonómetro gástrico utilizado para la monitorización y evaluación continua del pH.
Principales resultados:
- Para los pacientes ingresados con bajo pHi, las tasas de supervivencia fueron similares entre los grupos de protocolo y control (37% frente a 36%).
- Los pacientes ingresados con pHi normal mostraron una supervivencia significativamente mejorada en el grupo de protocolo en comparación con el grupo de control (58% vs 42%; p < 0,01).
- El protocolo de terapia guiada por pHi se inició en el 85% de los pacientes del grupo de protocolo que experimentaron una caída de pHi.
Conclusiones:
- La terapia guiada por mediciones del pH intramucoso gástrico (pHi) mejoró significativamente la supervivencia en pacientes de UCI con admisión normal pHi.
- La reanimación guiada por pHi puede mejorar los resultados al prevenir la hipoxia de órganos esplancánicos y el déficit sistémico de oxígeno.
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