World Journal of Surgery

, Volume 20, Issue 8, pp 988–991

Intraabdominal Pressure and Gastric Intramucosal pH: Is There an Association?

  • M. Sugrue
  • F. Jones
  • Anna Lee
  • M.D. Buist
  • S. Deane
  • A. Bauman
  • K. Hillman

DOI: 10.1007/s002689900149

Cite this article as:
Sugrue, M., Jones, F., Lee, A. et al. World J. Surg. (1996) 20: 988. doi:10.1007/s002689900149

Abstract. This study evaluated the potential association between increased intraabdominal pressure (IAP) and abnormally low gastric intramucosal pH (pHi) (≤ 7.32) in postoperative patients and assessed its effect on patient outcome. Altogether 73 patients undergoing major abdominal surgery over a 9-month period were studied prospectively. All underwent gastric tonometry and intravesical IAP measurements three time daily. An IAP of ≥ 20 mmHg and a pHi of ≤ 7.32 were considered abnormal. The development of the following complications were also documented: hypotension [mean aortic pressure (MAP) < 80 mmHg], abdominal sepsis, renal impairment, and death. The median APACHE II score was 16 (range 5–34). Twenty-two patients had upper gastrointestinal (GI) surgery, 27 lower GI surgery, and 24 aortic surgery; 44 of these patients underwent emergency surgery. Abnormal pHi (≤ 7.32) occurred in 36 patients while on the intensive care unit. Compared to patients with normal pHi, abnormal pHi patients were 11.3 times (3.2–43.5) [odds ratio ± 95% CI] more likely to have an increased IAP. Abnormal pHi was significantly associated with hypotension (χ2 = 6.8;

p = 0.009), sepsis (χ2 = 3.7;p = 0.06), renal impairment (χ2 = 28.3;p = 0.0000001), relaparotomy (χ2 = 4.1;p = 0.04), and death (χ2 = 9.7;p = 0.002). This study demonstrated a significant clinical association between increased IAP and abnormal pHi. An abnormally low pHi was associated with poor outcome.

Copyright information

© 1996 by the Société Internationale de Chir ugie

Authors and Affiliations

  • M. Sugrue
    • 1
  • F. Jones
    • 1
  • Anna Lee
    • 2
  • M.D. Buist
    • 2
  • S. Deane
    • 1
  • A. Bauman
    • 3
  • K. Hillman
    • 2
  1. 1.Department of Surgery, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney 2170, AustraliaAU
  2. 2.Department of Intensive Care, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney 2170, AustraliaAU
  3. 3.Department of Public Health, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney 2170, AustraliaAU