Intramucosal pH: What, How, Whom, When and Where?

  • R. G. Fiddian-Green
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine 1993 book series (YEARBOOK, volume 1993)

Abstract

The indirect measurement of intramucosal pH (pHi) is derived from the carbon dioxide pressure (PCO2) in the lumen of the gut and the bicarbonate in arterial blood. This measurement was first conceived in 1981 [1] as a means of testing the hypothesis that a fall in pHi was the primary determinant of bleeding from stress ulceration. It was recognized shortly thereafter that pHi provided a metabolic measure of the adequacy of gut mucosal oxygenation [2] and that stress ulceration in patients was almost certainly a manifestation of ischemic mucosal injury [3]. It was discovered that during shock, endogenous vasoconstrictors act selectively on gut vasculature [4] and that ischemic mucosal injury might be a putative cause of multiple systems organ failure (MOF). The possibility that the measurement of pHi might be valuable in monitoring patients was not seriously considered until late 1986 [5, 6], and the possibility that it might be used to detect hemodynamically compensated shock and as an end- point in resuscitation from shock became apparent in late 1988 [7]. Ten years after the indirect measurement of pHi was devised, it was shown that including a normal pHi as a final endpoint in resuscitation could improve outcome in ICU patients [8].

Keywords

Hydrolysis Catheter Dioxide Ischemia Europe 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1993

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  • R. G. Fiddian-Green

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