[Effectiveness of hemodynamic treatment guided by gastric intramucosal pH monitoring].
OBJECTIVE
To determine whether gastric intramucosal pH can be used as an indicator for the treatment of critically ill children.


METHODS
A protocol for hemodynamic treatment was tested in 34 critically ill children (medical and surgical patients). Endpoint was considered as normalization of gastric intramucosal pH. Hemodynamic complications were compared with another group of critically ill patients who received conventional treatment.


RESULTS
Treatment designed to improve tissue oxygenation (hemodynamic stabilization, volume expansion, and dobutamine perfusion) raised pHi values from 7.25 +/- 0.04 to 7.32 +/- 0.13 (p = 0.014). Seventy-three percent of the children with pHi < 7.30 presented hemodynamic complications. These findings were compared with the results obtained in a control group of 30 critically-ill children given conventional treatment in the pediatric intensive care unit. In this group, 93.8% of the children with a pHi < 7.30 developed hemodynamic complications.


CONCLUSIONS
We conclude that gastric intramucosal pHi can be useful as an indicator for the hemodynamic treatment of critically ill children.
Calvo Rey
C
C
Unidad de Cuidados Intensivos, Hospital Infantil La Paz.
Ruza Tarrío
F
F
Delgado Domínguez
M A
MA
López-Herce Cid
J
J
Dorao Martínez-Romillo
P
P
D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism*; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male