Validity of gastric intramucosal pH (pHi) for circulatory evaluation in pediatric patients.
OBJECTIVE
To determine if the measurement of gastric intramucosal pH (pHi) is useful for evaluation of circulatory status of critically ill pediatric patients.


METHODS
Prospective clinical study.


METHODS
General intensive care unit in a university hospital.


METHODS
Seven pediatric patients (mean age: 2 y.o.); six post-cardiac surgery, one receiving barbiturate therapy.


METHODS
Tonometric catheters were placed via nasogastric approach. pHi was measured after confirmation of the catheter position by X-ray.


RESULTS
Saturation of venous blood oxygen (SvO2), arterial keton body ratio (AKBR), serum lactate level and pHi were evaluated simultaneously. No patients survived with pHi below 7.22; pHi above 7.11 significantly correlated with SvO2 values (r = 0.814, p < 0.001); pHi below 7.11 did not show any significant correlation with SvO2. Whereas SvO2 values of under 40% were distributed in the pHi range from 7.11 to 7.19, pHi below 7.11 occurred when SvO2 values were more than 40%. AKBR and serum lactate level did not correlate with pHi.


CONCLUSIONS
pHi can be a useful parameter for evaluating the circulatory status of critically ill pediatric patients; it allows reliable evaluation of splanchnic and peripheral perfusion.
Kishimoto
Tomono
T
Intensive Care Unit, Osaka University Hospital, Suita, Japan.
Fujino
Yuji
Y
Nishimura
Shinya
S
Taenaka
Nobuyuki
N
Mashimo
Takashi
T
D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D005753:Gastric Mucosa; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D011237:Predictive Value of Tests