Tonometry of partial carbon dioxide tension in gastric mucosa use of saline, buffer solutions, gastric juice or air 英文参考文献.docVIP

/content/4/4/201 Commentary Tonometry of partial carbon dioxide tension in gastric mucosa: use of saline, buffer solutions, gastric juice or air AB Johan Groeneveld Free University Hospital, Amsterdam, The Netherlands Received: 23 May 2000 Accepted: 30 May 2000 Published: 20 June 2000 Crit Care 2000,4:201–203 ? Current Science Ltd Abstract Tonometry of gastric mucosal partial carbon dioxide tension (PCO ) has been forwarded as a 2 clinically applicable tool to monitor regional perfusion adequacy during circulatory failure. The technique is still not used widely, partly because of methodological problems. Current measurement principles are reviewed, with help of the report on PCO2 measurements in gastric juice and tonometer in this issue. Keywords: clinical use of tonometers, gastric partial carbon dioxide tension, gastric pH, tonometry technique Gastric mucosal PCO tonometry has evolved as a useful certain dwell time and after aspiration of the saline [1]. It has been recognized, however, that saline may yield erro- 2 adjunctive monitoring technique that is physiologically sound, simple and noninvasive, even though the precise methodology and interpretation of the results continue to be debated [1]. A supranormal gastric mucosal to arterial blood PCO2 has been regarded as indirect evidence for mucosal hypoperfusion [1]. Among the controversies are the issues of the need for gastric acid secretion suppres- sion and the best PCO2 measurement medium for gastric neous PCO values, and that the bias may depend on the 2 solution and the type of blood gas machine used to measure PCO [1,3–5]. Indeed, the bias may be buffer- 2 and pH-dependent [1,3,5]. Various buffer solutions have been proposed to circumvent PCO losses during handling 2 and measurement in the blood gas machine and to cir- cumvent underestimation of PCO2 in saline