Is there a role for gastric tonometry in critical care? Weighing the evidence for and against the procedure.

Abstract

Gastric tonometry is a noninvasive technique for early detection of splanchnic ischemia. Some studies have found that measurement of intramucosal pH (pHi) is able to predict outcome in critically ill patients. However, factors unrelated to splanchnic ischemia (for example, the presence of acid-base disorders or an intraluminal source of carbon dioxide) may skew results. Furthermore, accurate pHi measurement requires administration of an H2 blocker 60 to 90 minutes before patients undergo the procedure. Therefore, the role of gastric pHi in guiding therapy remains undefined.