Gastric Intramucosal Acidosis, pHi and the Tonometer: What is the Benefit for Patients?

  • H. Pargger
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1999)


The measurement of gastric intramucosal pH (pHi) with the help of a tonometer has advanced to becoming one of the standard monitoring possibilities in critically ill patients. The basis for the method was published in 1964 [1], and it was introduced in clinical practice in the second half of the 1980s. Up to now, however, only two clinical studies have been published demonstrating a benefit from measurement and therapy of low pHi values in intensive care patients [2, 3]. It is our belief that proof for usefulness of the pHi method is mandatory if further widespread use is to be justified. We conclude that many clinicians today use pHi measurements because there is a theoretical advantage for their patients, which may be justifiable for certain patients. The recent discussion on the indications, risks and value associated with pulmonary artery catheters [4–6], however, makes it clear that sooner or later the scientific community will force the protagonists of the method to show evidence of its usefulness. Then, we will need to have more to say than what is said today about pulmonary artery catheters, namely, that large prospective studies are missing, and should have been done a long time ago.


Abdominal Aortic Aneurysm Pulmonary Artery Catheter Multiple Organ Dysfunction Syndrome Surgical Intensive Care Unit Gastric Tonometry 
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© Springer-Verlag Berlin Heidelberg 1999

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  • H. Pargger

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