USE OF GASTRIC INTRAMUCOSAL PH AS A MONITOR DURING HEMORRHAGIC SHACK

During resuscitation of the patient suffering from hemorrhagic shock, it may be difficult to determine the adequacy of treatment in the acut e setting. The objective of these preliminary studies was to determine if monitoring perfusion of the gastrointestinal tract as estimated by gastric intramucosal pH (pHi) is useful as a guide during the treatme nt of hemorrhagic shock. Dogs were bled using a modified Wigger's meth od to a mean arterial blood pressure of 50 mmHg, and pHi was determine d 30, 60, 90, and 120 min later. Gastric intramucosal acidosis develop ed within 30 min of induction of hemorrhagic shock. It was also found that pHi decreases with relatively small amounts of blood loss. There was a significant fall in pHi following hemorrhage to a mean arterial pressure of 80 mmHg from a baseline pressure of 100 mmHg. Following th e reinfusion of shed blood, the pHi returned to baseline values within 30 min. it is concluded that measurements of pHi may be a useful moni tor in the evaluation and initial resuscitation of patients in hemorrh agic shock. (C) 1994 Wiley-Liss, Inc.