Prolonged intestinal mucosal acidosis is associated with multiple organ failure in human acute pancreatitis: gastric tonometry revisited.
OBJECTIVE
To evaluate whether multiple determinations of intramucosal pH (pHi) in acute pancreatitis (AP) patients could provide additional information of the disease severity during early hospitalization.


METHODS
Twenty-one patients suffering from acute pancreatitis were monitored by gastric tonometry in the first 72 h after hospital admission.


RESULTS
In the survivor group (n = 15) the initially low pHi values returned to normal level (pHi > or = 7.32) within 48 h (median pHi: d 1: 7.21; d 2: 7.32; d 3: 7.33). In contrast, pHi values in the non-survivor group n = 6) were persistently either below or in the low normal range (median pHi 7.12; 7.12; 7.07 respectively), but pHi differences between the two groups reached significance only after 24 h (P<0.01). Mucosal acidosis detected at any time during the monitored period was associated with the emergence of single or multiple organ dysfunction (P<0.01).


CONCLUSIONS
Prolonged gastric mucosal acidosis was associated with remote organ dysfunction and failure in Acute Pancreatitis, however, correlation with the fatal outcome became significant only 24 h after admission. Due to its non-invasive nature gastric tonometry may supplement the pro-inflammatory markers to achieve a multi-faceted monitoring of the disease.
Kovacs
Gabor C
GC
3rd Department of Surgery, Semmelweis University Budapest, Hungary. gkov@seb3.sote.hu
Telek
Geza
G
Hamar
Janos
J
Furesz
Jozsef
J
Regoly-Merei
Janos
J
D000138:Acidosis / Q000378:metabolism / Q000503:physiopathology; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007413:Intestinal Mucosa / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009102:Multiple Organ Failure; D010195:Pancreatitis / Q000175:diagnosis / Q000503:physiopathology*; D011237:Predictive Value of Tests