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iPH and Splanchnic Dysfunction Management

  • S. M. Jakob
Conference paper

Abstract

There is evidence from experimental and clinical studies that the gastrointestinal tract is a key player in the development of endotoxemia, sepsis, and multiple organ failure [1, 2, 3, 4]. Therefore, the assessment of perfusion and function of the splanchnic organs have become of major interest, both for investigators and clinicians. The currently available clinical tools are, among others, the assessment of gastrointestinal permeability, liver function tests, such as monoethylglycine xylidide (MEGX) production from lidocaine, and many others, regional and local blood flow measurements, such as estimation of splanchnic blood flow by hepatic uptake of substances that are metabolized by the liver and distributed in the plasma, such as indocyanine green, Laser Doppler flow, and tonometry. The estimation of gastric and intestinal mucosal pH by tonometry was introduced in the 1980, and further developed during the last 15 years to semi- and fully automated methods. An impressive number of both clinical and experimental studies has been conducted so far with tonometry, but the method has not yet gained clinical acceptance. There are many reasons for this. Some are listed in Table 1.

Keywords

Splanchnic Blood Flow Gastric Tonometry Laser Doppler Flow Hepatic Arterial Blood Flow Mucosal Perfusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2002

Authors and Affiliations

  • S. M. Jakob
    • 1
  1. 1.Department of Intensive Care MedicineUniversity HospitalBernSwitzerland

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