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. 2007 Oct;63(4):337-40.
doi: 10.1016/S0377-1237(07)80010-4. Epub 2011 Jul 21.

Gastric Tonometry as a Prognostic Index of Mortality in Sepsis

K K Upadhyay  1 , V P Singh  2 , Tvsp Murthy  3
Affiliations

Gastric Tonometry as a Prognostic Index of Mortality in Sepsis

K K Upadhyay et al. Med J Armed Forces India. 2007 Oct.

Abstract

Background: Splanchnic hypoperfusion in sepsis leads to translocation of bacteria from gut and development of multi-organ dysfunction syndrome (MODS), with increased mortality in critically ill patients. Gastric tonometry can detect this hypoperfusion by measuring carbon dioxide tension (PgCO2) and intramucosal pH (pHi) from gastric mucosa. Therapeutic intervention aimed at improving gut perfusion can improve the outcome and prognosticate the mortality in sepsis patients.

Methods: 100 patients with clinical diagnosis of sepsis were included and divided into two groups of 50 each. Group A patients were managed traditionally without gastric tonometry and in Group B gastric tonometry was used for therapeutic intervention. The intramucosal PCO2, pHi, end tidal carbon dioxide tension (EtCO2) and (PgCO2-EtCO2) differences were monitored at 0, 12 and 24 hours interval.

Result: Overall mortality in Group A was 64 % and 54 % in Group B. In Group B 45% patients developed MODS and 54 % died with low pHi. As an index of mortality low pHi had a sensitivity of 70% and specificity of 65%.

Conclusion: There is a good correlation between mortality prediction on the basis of pHi and PgCO2-EtCO2 difference and actual mortality in critically ill patients. The gastric tonometer should be used to predict mortality and guide resuscitation in septicemia.

Keywords: Gastric tonometry; Multi-organ dysfunction syndrome; Sepsis; Splanchnic hypoperfusion.

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Figures

Fig. 1
Fig. 1
Gastric tonometer catheter
Fig. 2
Fig. 2
Datex Ohmeda S/5 monitor-gastric tonometer
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References

    1. Meakins JL, Marshall JC. The gastrointestinal tract: the motor of MOF. Archives of Surgery. 1986;121:197–201.
    1. Doglio GR, Pusajo JF. Gastric mucosal pH as a prognostic index of mortality in critically ill patients. Critical care medicine. 1991;19:1037–1040. - PubMed
    1. Friedman G, Berlot G. Combined measurement of blood lactate concentrations and gastric intramucosal pH in patients with severe sepsis. Critical care medicine. 1995;23:1184–1193. - PubMed
    1. Fiddian-Green RG. Gastric intramucosal pH, tissue oxygenation and acid-base balance. British Journal of Anaesthesia. 1995;74:591–606. - PubMed
    1. Nelson DP, King CE. Systemic and intestinal limits of O2 extraction in the dog. Journal of Applied Physiology. 1987;63:387–394. - PubMed