Prolonged intestinal mucosal acidosis is associated with multiple organ failure in human acute pancreatitis: gastric tonometry revisited

World J Gastroenterol. 2006 Aug 14;12(30):4892-6. doi: 10.3748/wjg.v12.i30.4892.

Abstract

Aim: To evaluate whether multiple determinations of intramucosal pH (pHi) in acute pancreatitis (AP) patients could provide additional information of the disease severity during early hospitalization.

Methods: Twenty-one patients suffering from acute pancreatitis were monitored by gastric tonometry in the first 72 h after hospital admission.

Results: In the survivor group (n = 15) the initially low pHi values returned to normal level (pHi > or = 7.32) within 48 h (median pHi: d 1: 7.21; d 2: 7.32; d 3: 7.33). In contrast, pHi values in the non-survivor group n = 6) were persistently either below or in the low normal range (median pHi 7.12; 7.12; 7.07 respectively), but pHi differences between the two groups reached significance only after 24 h (P<0.01). Mucosal acidosis detected at any time during the monitored period was associated with the emergence of single or multiple organ dysfunction (P<0.01).

Conclusion: Prolonged gastric mucosal acidosis was associated with remote organ dysfunction and failure in Acute Pancreatitis, however, correlation with the fatal outcome became significant only 24 h after admission. Due to its non-invasive nature gastric tonometry may supplement the pro-inflammatory markers to achieve a multi-faceted monitoring of the disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis* / metabolism
  • Acidosis* / physiopathology
  • Adult
  • Aged
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Intestinal Mucosa* / metabolism
  • Intestinal Mucosa* / physiopathology
  • Male
  • Manometry*
  • Middle Aged
  • Multiple Organ Failure*
  • Pancreatitis / diagnosis
  • Pancreatitis / physiopathology*
  • Predictive Value of Tests