Prognostic value of gastric tonometry in patients with intestinal obstruction
© BioMed Central Ltd 2003
Published: 3 March 2003
Background and goals
Intestinal failure can be accompanied by intra-abdominal hypertension (IAH) . Gastrointestinal ischaemia occurs particularly because of IAH . The index of gut luminal PCO2 referenced to arterial PCO2 (PgCO2–PaCO2) reflects an adequacy of splanchnic tissue perfusion and is a predictor of any later complications .
Materials and methods
We studied 24 patients with diagnosis of intestinal obstruction. The survey patients were nearly homogeneous on age (average age 46 ± 4 years) and preoperative condition (APACHE II score 18 ± 1.8). One-half of patients were males. The same technique of anesthesia was carried out in all the patients. IAP and PgCO2–PaCO2 (kPa) were measured by TRIP NGS catheter and Tonocap monitor preoperatively. Cluster analysis was performed on the base of preoperative differences between IAP and PgCO2–PaCO2.
On the results of cluster analysis, the patients were allocated into two groups. In 14 patients (group 1) the mean of pre-operative IAP was 1.82 ± 0.14 kPa. IAP was 0.41 ± 0.06 kPa in 10 patients of the second group (P < 0.05). Patients with higher IAP had 2.24 ± 0.42 PgCO2–PaCO2vs 1.49 ± 0.32 in group 2 (P < 0.05). Study of outcomes revealed that six patients of the group 1 had different serious complications and seven died. Eight patients from group 2 recovered without complications.
A higher level of PgCO2–PaCO2 because of increased IAP in patients with intestinal obstruction may have a prognostic value.
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