GASTRIC INTRAMUCOSAL PH PREDICTS DEATH IN SEVERE ACUTE-PANCREATITIS

Background This study tested the hypothesis that gastric intramucosal pH (pHi) can predict death in severe acute pancreatitis. Methods Seven teen consecutive patients with predicted severe acute pancreatitis wer e studied prospectively. Four died from complications related to pancr eatitis. Gastric pHi tvas measured by nasogastric tonometry al least e very 12 h for the first 48 h after admission and then on a daily basis during the first week. Results The lowest pHi recorded during the fir st 48 h was significantly less in those admitted to the intensive care unit than that in those who remained on the surgical ward (P = 0.0015 ) and in nonsurvivors compared with the survivors (P = 0.009). A recei ver-operator characteristic curve defined a pHi of 7.25 as the optimal cut-off point to predict death (sensitivity 100 per cent, specificity 77 per cent, overall predictive value 82 per cent. Conclusion These r esults suggest that splanchnic ischaemia may be an important determina nt of outcome in patients with severe acute pancreatitis.