Gastric tonometry in patients with sepsis. Effects of dobutamine infusions and packed red blood cell transfusions.
We wanted to determine the efficacy of dobutamine infusions and Prbc transfusions on splanchnic tissue oxygen utilization by measuring gastric pHi. Physiologic parameters and pHi measurements via the use of a gastric tonometer were obtained in 21 septic patients before and after the administration of a dobutamine infusion (5 micrograms/kg/min) or the transfusion of two units of Prbc. Subsets of measurements with normal (greater than 7.32) and with low (less than 7.32) pHi were separately analyzed for each intervention. In the dobutamine low pHi group, pHi increased significantly from 7.16 +/- 0.03 to 7.24 +/- 0.03 (n = 9, p less than 0.05). In contrast, pHi failed to increase in the Prbc low pHi subgroup (7.16 +/- 0.05 to 7.17 +/- 0.04 [n = 10, p greater than 0.80]). We conclude that dobutamine rather than Prbc transfusions should be administered to reverse gastric intramucosal acidosis.
Silverman
H J
HJ
Department of Medicine, University of Maryland School of Medicine, Baltimore.
Tuma
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016913:Blood Component Transfusion; D004280:Dobutamine / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000378:metabolism*; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D018805:Sepsis / Q000150:complications*; D013270:Stomach / Q000098:blood supply / Q000187:drug effects
D004280:Dobutamine