Skip to main content
SpringerLink
Log in

Gastric Tonometry

  • Chapter
  • First Online:
Monitoring Technologies in Acute Care Environments

  • 2997 Accesses

Abstract

Gastric tonometry is an indirect measurement of gastric intramucosal pH (pHim) as an indicator of splanchnic tissue ischemia. Through the direct measurement of intraluminal gastric CO2, the pHim can be calculated using the Henderson-Hasselbalch equation. When performed intermittently, this monitor can provide valuable insight into the adequacy of volume resuscitation and cardiac output augmentation. This monitor has been validated as a prognostic indicator in various patient populations. Further study is needed to validate the use of gastric tonometry as a guide to therapy. The only device required to monitor pHim is an NG tube equipped with a gas permeable balloon tip. Gastric tonometry is an inexpensive, minimally invasive monitor of tissue oxygenation in a specific high-risk anatomical location for complications associated with tissue ischemia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Maynard N, Bihari D, Beale R, Smithies M, Baldock G, Mason M, et al. Assessment of splanchnic oxygenation by gastric tonometry in patients with acute circulatory failure. JAMA. 1993;270(10):1203–10.

    Article  PubMed  CAS  Google Scholar 

  2. Gilmour DG, Aitkenhead AR, Hothersall AP, Ledingham IM. The effect of hypovolaemia on colonic blood flow in the dog. Br J Surg. 1980;67(2):82–4.

    Article  PubMed  CAS  Google Scholar 

  3. Bailey RW, Bulkley GB, Levy KI, Anderson JH, Zuidema GD. Pathogenesis of non-occlusive mesenteric ischaemia: studies in a porcine model induced by pericardial tamponade. Surg Forum. 1982;33:194–6.

    Google Scholar 

  4. Heard SO, Helsmoortel CM, Kent JC, Shahnarian A, Fink MP. Gastric tonometry in healthy volunteers: effect of ranitidine on calculated intramural pH. Crit Care Med. 1991;19(2):271–4.

    Article  PubMed  CAS  Google Scholar 

  5. Kirton OC, Windsor J, Wedderburn R, Hudson-Civetta J, Shatz DV, Mataragas NR, et al. Failure of splanchnic resuscitation in the acutely injured trauma patient correlates with multiple organ system failure and length of stay in the ICU. Chest. 1998;113(4):1064–9. Landow L, Phillips DA, Heard SO, Prevost D, Vandersalm TJ, Fink MP. Gastric tonometry and venous oximetry in cardiac surgery patients. Crit Care Med. 1991;19(10):1226–33.

    Google Scholar 

  6. Gutierrez G, Palizas F, Doglio G, Wainsztein N, Gallesio A, Pacin J, et al. Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet. 1992;339(8787):195–9.

    Article  PubMed  CAS  Google Scholar 

  7. Boyd O, Mackay CJ, Lamb G, Bland JM, Grounds RM, Bennett ED. Comparison of clinical information gained from routine blood-gas analysis and from gastric tonometry for intramural pH. Lancet. 1993;341(8838):142–6.

    Article  PubMed  CAS  Google Scholar 

  8. Rassias AJ, Ball PA, Corwin HL. A prospective study of tracheopulmonary complications associated with the placement of narrow-bore enteral feeding tubes. Crit Care. 1998;2(1):25–8.

    Article  PubMed  Google Scholar 

  9. Low LL, Harrington GR, Stoltzfus DP. The effect of arterial lines on blood-drawing practices and costs in intensive care units. Chest. 1995;108(1):216–9.

    Article  PubMed  CAS  Google Scholar 

  10. Ivatury RR, Simon RJ, Islam S, Fueg A, Rohman M, Stahl WM. A prospective randomized study of end points of resuscitation after major trauma: global oxygen transport indices versus organ-specific gastric mucosal pH. J Am Coll Surg. 1996;183(2):145–54.

    PubMed  CAS  Google Scholar 

  11. Pargger H, Hampl KF, Christen P, Staender S, Scheidegger D. Gastric intramucosal pH-guided therapy in patients after elective repair of infrarenal abdominal aneurysms: is it beneficial? Intensive Care Med. 1998;24(8):769–76.

    Article  PubMed  CAS  Google Scholar 

  12. Gomersall CD, Joynt GM, Freebairn RC, Hung V, Buckley TA, Oh TE. Resuscitation of critically ill patients based on the results of gastric tonometry: a prospective, randomized, controlled trial. Crit Care Med. 2000;28(3):607–14.

    Article  PubMed  CAS  Google Scholar 

  13. Levy B, Bollaert PE, Charpentier C, Nace L, Audibert G, Bauer P, et al. Comparison of norepinephrine and dobutamine to epinephrine for hemodynamics, lactate metabolism, and gastric tonometric variables in septic shock: a prospective, randomized study. Intensive Care Med. 1997;23(3):282–7.

    Article  PubMed  CAS  Google Scholar 

  14. Wilkes NJ, Woolf R, Mutch M, Mallett SV, Peachey T, Stephens R, et al. The effects of balanced versus saline-based hetastarch and crystalloid solutions on acid–base and electrolyte status and gastric mucosal perfusion in elderly surgical patients. Anesth Analg. 2001;93(4):811–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Vanderbilt University Medical Center, 1211 21st Ave S, Medical Arts Building Suite 526, Nashville, TN, 37212, USA

    William T. Costello MD

Authors
  1. William T. Costello MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William T. Costello MD .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology, Surgery, and Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

    Jesse M. Ehrenfeld

  2. Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, California, USA

    Maxime Cannesson

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Costello, W.T. (2014). Gastric Tonometry. In: Ehrenfeld, J., Cannesson, M. (eds) Monitoring Technologies in Acute Care Environments. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8557-5_38

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8557-5_38

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8556-8

  • Online ISBN: 978-1-4614-8557-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation