Adequacy of tissue oxygenation in intact dog intestine

Grum, Cyril M.; Fiddian-Green, Richard G.; Pittenger, Gary L.; Grant, B. J. B.; Rothman, Edward D.; Dantzker, David R.

doi:10.1152/jappl.1984.56.4.1065

Cited by 259 publications

(99 citation statements)

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“…(17) Maintenance of the blood flow is the most relevant aspect to keep intestinal oxygen consumption. (18) This set of data suggests that tissue perfusion is a relevant point for development of GID, in agreement with several physiological studies. (18)(19)(20)(21) A low admission oxygenation index, i.e., lower than 200 PaO 2 /FiO 2 , increased the risk of GID by more than 12 times.…”

Section: Discussionsupporting

confidence: 90%

“…(18) This set of data suggests that tissue perfusion is a relevant point for development of GID, in agreement with several physiological studies. (18)(19)(20)(21) A low admission oxygenation index, i.e., lower than 200 PaO 2 /FiO 2 , increased the risk of GID by more than 12 times. Acute lung injury (ALI) is a common cause for ICU admission, and was seen in 42% of the patients within the first 48 hours following admission.…”

Section: Discussionsupporting

confidence: 90%

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Disfunção do trato gastrointestinal prolongada em pacientes admitidos na terapia intensiva

Lobo¹,

Miranda²

2010

Rev. bras. ter. intensiva

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Disfunção do trato gastrointestinal prolongada em pacientes admitidos na terapia intensiva

Lobo¹,

Miranda²

2010

Rev. bras. ter. intensiva

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“…Estimation of pHim by the tonometric technique appears to be a sensitive indicator of splanchnic oxygenation [21], and the value of pHim is closely related to the gastric mucosal blood flow [22]. Patients in whom weaning failed had no evident cause of gastrointestinal hypoxia, such as the sepsis syndrome, hypovolaemia or left ventricular failure, while they were mechanically ventilated.…”

Section: Discussionmentioning

confidence: 99%

Gastric intramucosal pH: an indicator of weaning outcome from mechanical ventilation in COPD patients

Bouachour¹,

Guiraud²,

Jp³

et al. 1996

Eur Respir J

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G Ga as st tr ri ic c i in nt tr ra am mu uc co os sa al l p pH H: : a an n i in nd di ic ca at to or r o of f w we ea an ni in ng g o ou ut tc co om me e f fr ro om m m me ec ch ha an ni ic ca al l v ve en nt ti il la at ti io on n i in n C CO OP PD D p pa at ti ie en nt ts s G. Bouachour, M-P. Guiraud, J-P. Gouello, P-M. Roy, P. Alquier ABSTRACT: The aim of this study was to determine whether gastric intramucosal pH (pHim) and/or gastric intramucosal carbon dioxide tension (PCO 2 ,im) measured by tonometry can be used to predict the success of weaning in chronic obstructive pulmonary disease (COPD) patients. Twenty six consecutive COPD patients, undergoing mechanical ventilation for acute respiratory failure and satisfying the criteria of weaning from mechanical ventilation with nasogastric tonometer in place, were studied. Arterial blood gas values and PCO 2 ,im were measured 24 h before (H-24), just before (H0), and after 20 min of a weaning trial on T-piece (H20min). Weaning failure was defined as the development of respiratory distress and/or arterial blood gas impairments during the first 2 h of spontaneous breathing on T-piece, or reintubation within 24 h after extubation.Between the weaning failure (n=6) and weaning success (n=20) groups, there were no differences in blood gas analysis readings at H-24 and H0 before the weaning period, age, Simplified Acute Physiology Score (SAPS) on admission, SAPS on the day of weaning trial, and duration of ventilation. Clinical status, tonometric and arterial gasometric data were similar at H-24 and H0 in all patients. During mechanical ventilation, pHim was ≤7.30 in patients who failed weaning and >7.30 in patients who were successfully weaned (p<0.001; 100% sensitivity and specificity). The threshold value for PCO 2 ,im of 8.0 kPa (60 mmHg) represents a clear demarcation with respect to outcome before the weaning trial. PCO 2 ,im values during mechanical ventilation are significantly different (p<0.001) between patients who were successfully weaned and those who were not (6.9±0.9 vs 9.9±1.1 kPa (51.9±6.7 vs 74.3±8.0 mmHg, respectively)). At H20min, pHim and PCO 2 ,im were still statistically different between the weaning failure and the weaning success group.We conclude that measurement of gastric intramucosal pH (or gastric intramucosal carbon dioxide tension) represents a simple and accurate index to predict weaning outcome in chronic obstructive pulmonary disease patients before attempting weaning.

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“…If the arterial HC0,-concentration is known, the pHi can be calculated. The HC0,-concentration in the wall of the gut was assumed to be the same as that in arterial blood [19]. The balloon of the tonometer, placed in the terminal ileum, was filled with 2.5 ml saline via the rubber tube.…”

Section: Methodsmentioning

confidence: 99%

Intramucosal pH and intestinal mucosal damage in ischemia-reperfusion injury

et al. 1998

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Small bowel transplantation (SBT) has become an increasingly promising treatment for short bowel syndrome. The evaluation of graft viability after SBT, however, has not been established, except by mucosal biopsy. We monitored intestinal mucosal acidity in order to detect small intestinal ischemia-reperfusion injury. Mongrel dogs were used in this study. After laparotomy, the small bowel was isolated with a vascular pedicle. A tonometer to measure intramucosal p H (pHi) was then positioned in the terminal ileum. The superior mesenteric artery was occluded with or without concomitant superior mesenteric vein occlusion for 60 or 120 min. The value of pHi was determined from laparotomy (baseline) to 12 h after reperfusion. Whole-thickness specimens of the ileum were taken before ischemia, just before reperfusion, and 1 h afterward. Mucosal injury was graded histopathologically. pHi decreased from baseline in relation to the degree of histopathological mucosal injury. There was a significant correlation between histological findings and the change in pHi. We conclude that monitoring intestinal mucosal acidity is a reliable way of determining graft viability after SBT.

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Adequacy of tissue oxygenation in intact dog intestine

Cited by 259 publications

References 0 publications

Disfunção do trato gastrointestinal prolongada em pacientes admitidos na terapia intensiva

Disfunção do trato gastrointestinal prolongada em pacientes admitidos na terapia intensiva

Gastric intramucosal pH: an indicator of weaning outcome from mechanical ventilation in COPD patients

Intramucosal pH and intestinal mucosal damage in ischemia-reperfusion injury

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