Prognostic value of gastric intramucosal pH in critically ill children

Critical Care Medicine
J Casado-FloresM J Ruiz-López

Abstract

To determine the association of tonometrically measured gastric intramucosal pH (pHi) to the occurrence of multiple organ dysfunction syndrome (MODS) and death in critically ill children. Prospective, observational study. Pediatric intensive care unit (ICU) of a teaching children's hospital. Fifty-one critically ill children admitted (median age 5.4+/-5 [SD] yrs; range 1 mo to 16 yrs) with the following diagnoses: post major surgery (n=26), sepsis (n=8), multiple trauma (n=5), acute respiratory distress syndrome (n=4), and "miscellaneous" (n=8). Placement of a tonometric catheter. Pediatric Risk of Mortality (PRISM) score and clinical data were collected on admission and pHi daily during their stay in the pediatric ICU. A sigmoid tonometer was used to determine the pHi. Unconditional logistic regression was used to investigate the prognostic value of pHi. On admission, 26 patients presented with low gastric pHi (< or =7.35) and 17 of them had values of <7.30. The mortality rate in children with pHi <7.30 was 47.1% (95% confidence interval, 26.2 to 69) in contrast with an 11.7% mortality rate (95% confidence interval, 4.6 to 26.6) in children having a pHi of > or =7.30 (p=.015). The pHi and PRISM score on admission were independ...Continue Reading

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Citations

Dec 16, 2011·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Michael BergerMartin Lacher
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