[Development of gastrotonometry and the future of its use in the monitoring of critically ill patients]

Abstract

Gastrotonometry conventionally enables the measurement of the partial pressure of carbon-dioxide (pCO2) in the gastric mucosa via the analysis of the filling material of a ballooned probe placed into the stomach. According to the data of the more than a half century long history of the method we may state, that the examination triggered an unusually large interest as well as was applied both in clinical work and in research. Since in the case of good circulatory circumstances the result of the examination is nearly equal to the value of the arterial blood pCO2, in the beginning the method was used for the better setting of ventilators of poliomyelitic patients with respiratory paralysis. Later it was also explored, that in critically ill patients the pCO2 value is significantly higher, than that of the arterial blood value, which difference is the consequence of the disturbance in the regional perfusion of the gastrointestinal system. The attention toward the subject was mainly drawn by the circumstance that the examination of the patient's condition can be judged objectively. Even more important is that gastrotonometry may help in the prediction of a life-threatening event. One of the main purposes of the article was the summarising of the literature on the subject, as well as reviewing the aspects, which should urge clinicians to apply gastrotonometry in a broader range of everyday clinical practice. On the other hand, the authors also give a short description of a new, self-developed balloon-free probe.