title: Prolonged intestinal mucosal acidosis is associated with multiple organ failure in human acute pancreatitis: gastric tonometry revisited.
abstract: 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.
authors.affiliation: 3rd Department of Surgery, Semmelweis University Budapest, Hungary. gkov@seb3.sote.hu
authors.forename: Gabor C
authors.initials: GC
authors.lastname: Kovacs
authors.forename: Geza
authors.initials: G
authors.lastname: Telek
authors.forename: Janos
authors.initials: J
authors.lastname: Hamar
authors.forename: Jozsef
authors.initials: J
authors.lastname: Furesz
authors.forename: Janos
authors.initials: J
authors.lastname: Regoly-Merei
mesh_terms: 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