Gastric tonometry in patients recovering from paracetamol overdose

Objectives

To investigate the relationship between gastric intra-mucosal pH and recovery from paracetamol overdose.

Design

Patients admitted to the liver intensive care unit, not fulfilling transplantation criteria, were prospectively enrolled. A gastrointestinal tonometer was placed into the stomach and the intramucosal pH was calculated every day until 10 days post overdose, by an intermittent saline bolus technique.

Results

14 patients were studied, of which 2 subsequently died. Data are presented as a box and whisker chart, with the box representing medians, 25th and 75th quartiles and the whiskers the range. (*P value of 0.01 to 0.05 and **P value of 0.001 to 0.01 when compared to day 3).

Results

Conclusions

Gastric intramucosal pH significantly falls in the recovery phase of paracetamol overdose and this is not related to outcome. This may represent diversion of blood away from the portal system to the regenerating liver.