Gastric tonometry in assessing splanchnic tissue perfusion in acute pancreatitis.
BACKGROUND
Hypovolemia is typical early in acute pancreatitis. Despite fluid resuscitation splanchnic hypoperfusion may be present and may have a role in the course of pancreatitis. To test this hypothesis, we assessed gastric mucosal pH (pHi) and P(CO)2 during the first 48 h of hospitalization for acute pancreatitis.


METHODS
Thirty-three patients were studied. A gastric tonometer was inserted on admission, and gastric mucosal pH and P(CO)2 were measured on admission and then every 12 h during next 48 h.


RESULTS
On the basis of the Atlanta classification there were 22 cases of mild and 8 of severe pancreatitis. Three patients were excluded because of consent withdrawal. The groups were similar with regard to age, sex ratio, and etiology of pancreatitis. Independently of disease severity the gastric pHi decreased, and the gastric mucosal-arterial P(CO)2 difference and pH difference both increased over time as compared with base line. No difference was seen in these values between mild and severe pancreatitis.


CONCLUSIONS
Moderate gastric mucosal hypoperfusion was found early in acute pancreatitis. However, gastric pHi measurement with tonometry has no obvious value as a screening tool to assess the severity of pancreatitis.
Juvonen
P O
PO
Dept. of Surgery, Critical Care Research Programme, Kuopio University Hospital, Finland.
Alhava
E M
EM
Takala
J A
JA
D000208:Acute Disease; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010195:Pancreatitis / Q000503:physiopathology*; D012720:Severity of Illness Index; D013152:Splanchnic Circulation / Q000502:physiology*; D013270:Stomach / Q000503:physiopathology