ISSN:
1573-2568
Keywords:
gastric acidity determination
;
variation of gastric acidity
;
intensive care unit patients
;
postoperative period
;
stress ulceration
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract To gain insight into the variation over time of gastric acidity in postoperative ICU patients, intragastric pH was prospectively studied in patients undergoing elective abdominal aortic reconstructive surgery during a 72-hr intra- and postoperative period. Intragastric pH was monitored continuously in 14 patients with combined glass electrodes. During the day of surgery (day 1), the median 24-hr pH for all patients was 6.25 (5.8–7.0, IQR). However, three of the 14 studied patients had a median 24-hr pH of 1.8. The median 24-hr pH throughout day 2 for all was 2.45 (1.6–4.7,P=0.001). The median 24-hr pH on day 3 was 1.6 (1.5–2.1,P=0.001). Median 8-hr pH values demonstrate a remarkable interpatient and intraindividual variation in the course of the postoperative period. A progressive lowering of the intragastric pH was observed in the first 40 hr. From the 40- to 48-hr interval until the end of the study, no further significant decrease was found. The intragastric pH was above 4, 74% of the time during day 1, 39% during day 2 (P=0.006) and 16% during day 3 (P=0.003). Percentage of time above 4 on day 2 was significantly higher than on day 3 (P=0.04). In conclusion, since gastric acid and pepsin seem to play a role in stress ulceration, this study suggests some patients are at risk of stress ulceration from the beginning of surgery, but most patients become at risk of stress ulceration in the course of the postoperative period.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF02087763
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