Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Equipment review: Gastric intramucosal pH measurement. | Baigorri et al. Critical Care 1997 1 61 http c CRITICAL CARE REVIEW Equipment review Gastric intramucosal pH measurement Francisco Baigorri Xavier Calvet Domenec Joseph 64cc-1-2-061 Introduction Gastric tonometry has emerged as an attractive relatively noninvasive technology for assessing gastrointestinal perfusion and oxygenation by detecting acidosis in the gut wall. Several clinical studies have shown that gastric intramucosal acidosis detected by this procedure predicts increased mortality of critcally ill adults in medical and surgical intensive care unit ICU settings 1-3 and that it is a better predictor of mortality from critical illness than other mesures of global oxygen delivery and systemic hemodynamics 4 . It has also been suggested that correcting intramucosal acidosis may increase survival in selected critically ill patients 5 . The purpose of this review is to discuss factors influencing in vivo reliability and variability of gastric tonometry and to analyze the causes of the occasional misinterpretation of its results. The gastric tonometry technique causes of misinterpretation of the results The measurement of gastric mucosal acidosis by gastric tonometry is based on the principle that the fluid in a hollow viscus can be used to estimate gas tensions in the surrounding tissues. The main assumption is that after a given equilibration time luminal and mucosal CO2 partial pressures PCO2 will be similar. Consequently the increased tissue production of CO2 during hypoxia from the reaction between hydrogen anions and bicarbonate can be detected by analyzing the liquid inside the gastric lumen. Conventional gastric tonometry involves the placement of a modified nasogastric NG tube equipped with a gas-permeable saline-filled silicone balloon at its tip into the stomach 6 7 Fig 1 . Allowing enough time for the equilibration of CO2 between the fluid in the balloon and the gastric lumen 30-90 min the Intensive Care Service Hospital de Sabadell .
