Does gastric tonometry work? No.
Gastrointestinal tonometry is supposed to diagnose gut mucosal hypoxia using gastric luminal PCO2 and arterial bicarbonatemia, which are substituted in a modified Henderson-Hasselbach equation. This article reviews some of the problems inherent to the multiple assumptions underlying this technique. Tonometry is influenced by several local factors and by systemic acid-base imbalances that are unrelated to oxygenation. Tonometry is a rather crude and cumbersome method of gut capnometry, a technology that may provide valuable information regarding visceral perfusion, but not necessarily oxygenation.
Benjamin
E
E
Department of Surgery, Mount Sinai Medical Center, City University of New York, New York, USA.
Oropello
J M
JM
D015982:Bias; D001785:Blood Gas Monitoring, Transcutaneous / Q000009:adverse effects / Q000592:standards*; D015687:Cell Hypoxia; D003422:Critical Care; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007511:Ischemia / Q000175:diagnosis*; D008365:Manometry / Q000009:adverse effects / Q000592:standards*; D008991:Monitoring, Physiologic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity