title: Low gastric intramucosal pH: incidence and significance in intensive care patients.
abstract: Monitoring of gastric intramucosal pH (pHi) is advocated in critical illness to detect tissue acidosis due to regional hypoperfusion. However, the number of patients who may benefit from such monitoring remains unclear and the relationship between low pHi and outcome requires further definition. Sixty consecutive patients with Acute Physiology and Chronic Health Evaluation (APACHE II) scores < 30 were studied throughout ICU stay to investigate the incidence of low pHi (< 7.32 for > or = 1 hour), its relationship to outcome, and temporally associated clinical events. pHi was measured 2 to 6 hours post-ICU admission and 8-hourly thereafter. Forty-four patients (73%) exhibited low pHi. Fourteen patients died in ICU with 13 deaths occurring in the low pHi group (P = 0.05). Length of ICU stay was greater in the low pHi group (P = 0.02). The development of low pHi was temporally associated with maximal sepsis score, weaning from assisted ventilation and commencement of enteral feeding.
authors.affiliation: Regional Intensive Care Unit, Royal Victoria Hospital, N. Ireland, United Kingdom.
authors.forename: T J
authors.initials: TJ
authors.lastname: Trinder
authors.forename: G G
authors.initials: GG
authors.lastname: Lavery
authors.forename: J P
authors.initials: JP
authors.lastname: Fee
authors.forename: K G
authors.initials: KG
authors.lastname: Lowry
mesh_terms: D018806:APACHE; D000138:Acidosis / Q000503:physiopathology*; D001424:Bacterial Infections / Q000503:physiopathology; D003422:Critical Care; D004750:Enteral Nutrition; D005753:Gastric Mucosa / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007022:Hypotension / Q000503:physiopathology; D000860:Hypoxia / Q000503:physiopathology; D015994:Incidence; D007385:Intermittent Positive-Pressure Ventilation; D007902:Length of Stay; D008991:Monitoring, Physiologic; D009846:Oliguria / Q000503:physiopathology; D011379:Prognosis; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D015300:Ventilator Weaning