Gastrointestinal pHi as a therapeutic index in critically ill patients

In a prospective multicenter study Gutierre.z,et...aL (1992) tested the efficacy of pHi-guided therapy. A control group of ICU patients were treated according to standard

ICU practices, whereas the protocol group received, in addition, treatment to increase systemic O 2 transport whenever pHi fell below 7.35, or by more than 0.10 units from the previous measurements. The results of the study showed that survival for patients admitted with pHi < 7.35 was similar in the protocol and control groups (37 per cent versus 36 per cent), whereas survival for those admitted with normal pHi was significantly greater in the protocol group (58 per cent versus 42 per cent). These findings suggest that pHi-guided resuscitation may improve outcome in patients admitted to the ICU with normal pHi, perhaps by preventing splanchnic ischemia and the development of a systemic oxygen deficit.

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