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Jean Louis Vincent - One of the best experts on this subject based on the ideXlab platform.
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does Gastric Tonometry monitor splanchnic perfusion
Critical Care Medicine, 1999Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:Objective: To define whether the Gastric mucosal-arterial Pco 2 gradient (Pco 2 gap) reliably reflects hepatosplanchnic oxygenation In septic patients. Design: Prospective observational clinical study. Setting: An adult, 31-bed medical/surgical department of intensive care of a university hospital. Patients: A total of 36 hemodynamically stable, invasively monitored, mechanically ventilated, sedated, paralyzed patients with severe sepsis. Interventions: In each patient, hepatosplanchnic blood flow was determined by the continuous indocyanine green infusion technique and Gastric mucosal Pco 2 by the saline Tonometry technique. Suprahepatic venous blood oxygen saturation and Pco 2 also were measured. The mesenteric veno-arterial Pco 2 gradient was determined as the difference between the suprahepatic venous blood Pco 2 and the arterial blood Pco 2 . Measurements and Main Results: There were significant correlations between the hepatosplanchnic blood flow and the suprahepatic venous blood oxygen saturation (r 2 = .56; p <.01), between the hepatosplanchnic blood flow and the mesenteric veno-arterial Pco 2 gradient (r 2 =.55; p <.01), and also between the suprahepatic venous blood oxygen saturation and the mesenteric veno-arterial Pco 2 gradient (r 2 =.64; p <.01). There was no statistically significant correlation between the Pco 2 gap and the hepatosplanchnic blood flow, the suprahepatic venous blood oxygen saturation or the mesenteric veno-arterial PCO 2 gradient Conclusions: In stable septic patients, the Pco 2 gap is not correlated with global indexes of gut oxygenation. The interpretation of Pco 2 gap is more complex than previously thought.
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Does Gastric Tonometry monitor splanchnic perfusion
Critical care medicine, 1999Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:Objective: To define whether the Gastric mucosal-arterial Pco 2 gradient (Pco 2 gap) reliably reflects hepatosplanchnic oxygenation In septic patients. Design: Prospective observational clinical study. Setting: An adult, 31-bed medical/surgical department of intensive care of a university hospital. Patients: A total of 36 hemodynamically stable, invasively monitored, mechanically ventilated, sedated, paralyzed patients with severe sepsis. Interventions: In each patient, hepatosplanchnic blood flow was determined by the continuous indocyanine green infusion technique and Gastric mucosal Pco 2 by the saline Tonometry technique. Suprahepatic venous blood oxygen saturation and Pco 2 also were measured. The mesenteric veno-arterial Pco 2 gradient was determined as the difference between the suprahepatic venous blood Pco 2 and the arterial blood Pco 2 . Measurements and Main Results: There were significant correlations between the hepatosplanchnic blood flow and the suprahepatic venous blood oxygen saturation (r 2 = .56; p
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Monitoring Gastric mucosal carbon dioxide pressure using gas Tonometry: in vitro and in vivo validation studies.
Anesthesiology, 1997Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:BackgroundSaline Gastric Tonometry of carbon dioxide has been proposed as a means to assess the adequacy of splanchnic perfusion. However, this technique has several disadvantages, including the long time interval needed for gases to reach equilibrium in saline milieu. Thus the authors evaluated a s
Jukka Takala - One of the best experts on this subject based on the ideXlab platform.
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Gastric Tonometry in assessing splanchnic tissue perfusion in acute pancreatitis
Scandinavian journal of gastroenterology, 2000Co-Authors: P. O. Juvonen, E. Alhava, Jukka TakalaAbstract:Background: Hypovolemia is typical early in acute pancreatitis. Despite fluid resuscitation splanchnic hypoperfusion may be present and may have a role in the course of pancreatitis. To test this hypothesis, we assessed Gastric mucosal pH (pHi) and PCO2 during the first 48 h of hospitalization for acute pancreatitis. Methods: Thirty-three patients were studied. A Gastric tonometer was inserted on admission, and Gastric mucosal pH and PCO2 were measured on admission and then every 12 h during next 48 h. Results: On the basis of the Atlanta classification there were 22 cases of mild and 8 of severe pancreatitis. Three patients were excluded because of consent withdrawal. The groups were similar with regard to age, sex ratio, and etiology of pancreatitis. Independently of disease severity the Gastric pHi decreased, and the Gastric mucosal-arterial PCO2 difference and pH difference both increased over time as compared with base line. No difference was seen in these values between mild and severe pancreatitis....
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Gastric mucosal pH does not reflect changes in splanchnic blood flow after cardiac surgery
British journal of anaesthesia, 1995Co-Authors: Ari Uusaro, Esko Ruokonen, Jukka TakalaAbstract:Despite the widespread use of Gastric Tonometry to assess splanchnic oxygen transport, no human data are available on the relationship between splanchnic blood flow, splanchnic oxygen delivery and Gastric mucosal pH. We have studied the effect of splanchnic blood flow and oxygen delivery on Gastric mucosal pH after cardiac surgery. During the first postoperative hours of intensive care, dopexamine was infused to increase cardiac output in eight patients, while six patients served as controls. Gastric mucosal pH (Gastric Tonometry), splanchnic blood flow and splanchnic oxygen delivery and consumption (dye dilution) were measured. Dopexamine administration significantly increased splanchnic blood flow (0.72 vs 1.02 litre min−1 m−2 (P
Jacques Creteur - One of the best experts on this subject based on the ideXlab platform.
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does Gastric Tonometry monitor splanchnic perfusion
Critical Care Medicine, 1999Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:Objective: To define whether the Gastric mucosal-arterial Pco 2 gradient (Pco 2 gap) reliably reflects hepatosplanchnic oxygenation In septic patients. Design: Prospective observational clinical study. Setting: An adult, 31-bed medical/surgical department of intensive care of a university hospital. Patients: A total of 36 hemodynamically stable, invasively monitored, mechanically ventilated, sedated, paralyzed patients with severe sepsis. Interventions: In each patient, hepatosplanchnic blood flow was determined by the continuous indocyanine green infusion technique and Gastric mucosal Pco 2 by the saline Tonometry technique. Suprahepatic venous blood oxygen saturation and Pco 2 also were measured. The mesenteric veno-arterial Pco 2 gradient was determined as the difference between the suprahepatic venous blood Pco 2 and the arterial blood Pco 2 . Measurements and Main Results: There were significant correlations between the hepatosplanchnic blood flow and the suprahepatic venous blood oxygen saturation (r 2 = .56; p <.01), between the hepatosplanchnic blood flow and the mesenteric veno-arterial Pco 2 gradient (r 2 =.55; p <.01), and also between the suprahepatic venous blood oxygen saturation and the mesenteric veno-arterial Pco 2 gradient (r 2 =.64; p <.01). There was no statistically significant correlation between the Pco 2 gap and the hepatosplanchnic blood flow, the suprahepatic venous blood oxygen saturation or the mesenteric veno-arterial PCO 2 gradient Conclusions: In stable septic patients, the Pco 2 gap is not correlated with global indexes of gut oxygenation. The interpretation of Pco 2 gap is more complex than previously thought.
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Does Gastric Tonometry monitor splanchnic perfusion
Critical care medicine, 1999Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:Objective: To define whether the Gastric mucosal-arterial Pco 2 gradient (Pco 2 gap) reliably reflects hepatosplanchnic oxygenation In septic patients. Design: Prospective observational clinical study. Setting: An adult, 31-bed medical/surgical department of intensive care of a university hospital. Patients: A total of 36 hemodynamically stable, invasively monitored, mechanically ventilated, sedated, paralyzed patients with severe sepsis. Interventions: In each patient, hepatosplanchnic blood flow was determined by the continuous indocyanine green infusion technique and Gastric mucosal Pco 2 by the saline Tonometry technique. Suprahepatic venous blood oxygen saturation and Pco 2 also were measured. The mesenteric veno-arterial Pco 2 gradient was determined as the difference between the suprahepatic venous blood Pco 2 and the arterial blood Pco 2 . Measurements and Main Results: There were significant correlations between the hepatosplanchnic blood flow and the suprahepatic venous blood oxygen saturation (r 2 = .56; p
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Monitoring Gastric mucosal carbon dioxide pressure using gas Tonometry: in vitro and in vivo validation studies.
Anesthesiology, 1997Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:BackgroundSaline Gastric Tonometry of carbon dioxide has been proposed as a means to assess the adequacy of splanchnic perfusion. However, this technique has several disadvantages, including the long time interval needed for gases to reach equilibrium in saline milieu. Thus the authors evaluated a s
Michael G. Mythen - One of the best experts on this subject based on the ideXlab platform.
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Does Gastric Tonometry-guided therapy reduce total mortality in critically ill patients?
Critical care (London England), 2015Co-Authors: Michael G. MythenAbstract:Zhang and colleagues have recently published a systematic review and meta-analysis of six studies and conclude that ‘Gastric Tonometry guided therapy can reduce total mortality in critically ill patients’. So why did Gastric Tonometry come and go, and what can we learn from this piece of modern history?
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Understanding gastrointestinal perfusion in critical care: so near, and yet so far
Critical Care, 2000Co-Authors: Gareth Ackland, Michael Pw Grocott, Michael G. MythenAbstract:An association between abnormal gastrointestinal perfusion and critical illness has been suggested for a number of years. Much of the data to support this idea comes from studies using Gastric Tonometry. Although an attractive technology, the interpretation of Tonometry data is complex. Furthermore, current understanding of the physiology of gastrointestinal perfusion in health and disease is incomplete. This review considers critically the striking clinical data and basic physiological investigations that support a key role for gastrointestinal hypoperfusion in initiating and/or perpetuating critical disease.
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Current status of gastrointestinal Tonometry
Current Opinion in Critical Care, 2000Co-Authors: Ruth Hurley, Miriam V. Chapman, Michael G. MythenAbstract:The use of Gastric Tonometry for the measurement of splanchnic perfusion as a surrogate of tissue oxygen delivery is a well-established technique, but one that has not enjoyed widespread clinical usage. Automated air Tonometry, together with the measurement of Gastric to arterial or end-tidal alveolar differences in carbon dioxide tension, is starting to replace the use of saline Tonometry and the measurement of intramucosal pH. Although this technique is in the early stages of validation, it is thought that it will be a more clinically useful tool. (C) 2000 Lippincott Williams and Wilkins, Inc
Daniel De Backer - One of the best experts on this subject based on the ideXlab platform.
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does Gastric Tonometry monitor splanchnic perfusion
Critical Care Medicine, 1999Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:Objective: To define whether the Gastric mucosal-arterial Pco 2 gradient (Pco 2 gap) reliably reflects hepatosplanchnic oxygenation In septic patients. Design: Prospective observational clinical study. Setting: An adult, 31-bed medical/surgical department of intensive care of a university hospital. Patients: A total of 36 hemodynamically stable, invasively monitored, mechanically ventilated, sedated, paralyzed patients with severe sepsis. Interventions: In each patient, hepatosplanchnic blood flow was determined by the continuous indocyanine green infusion technique and Gastric mucosal Pco 2 by the saline Tonometry technique. Suprahepatic venous blood oxygen saturation and Pco 2 also were measured. The mesenteric veno-arterial Pco 2 gradient was determined as the difference between the suprahepatic venous blood Pco 2 and the arterial blood Pco 2 . Measurements and Main Results: There were significant correlations between the hepatosplanchnic blood flow and the suprahepatic venous blood oxygen saturation (r 2 = .56; p <.01), between the hepatosplanchnic blood flow and the mesenteric veno-arterial Pco 2 gradient (r 2 =.55; p <.01), and also between the suprahepatic venous blood oxygen saturation and the mesenteric veno-arterial Pco 2 gradient (r 2 =.64; p <.01). There was no statistically significant correlation between the Pco 2 gap and the hepatosplanchnic blood flow, the suprahepatic venous blood oxygen saturation or the mesenteric veno-arterial PCO 2 gradient Conclusions: In stable septic patients, the Pco 2 gap is not correlated with global indexes of gut oxygenation. The interpretation of Pco 2 gap is more complex than previously thought.
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Does Gastric Tonometry monitor splanchnic perfusion
Critical care medicine, 1999Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:Objective: To define whether the Gastric mucosal-arterial Pco 2 gradient (Pco 2 gap) reliably reflects hepatosplanchnic oxygenation In septic patients. Design: Prospective observational clinical study. Setting: An adult, 31-bed medical/surgical department of intensive care of a university hospital. Patients: A total of 36 hemodynamically stable, invasively monitored, mechanically ventilated, sedated, paralyzed patients with severe sepsis. Interventions: In each patient, hepatosplanchnic blood flow was determined by the continuous indocyanine green infusion technique and Gastric mucosal Pco 2 by the saline Tonometry technique. Suprahepatic venous blood oxygen saturation and Pco 2 also were measured. The mesenteric veno-arterial Pco 2 gradient was determined as the difference between the suprahepatic venous blood Pco 2 and the arterial blood Pco 2 . Measurements and Main Results: There were significant correlations between the hepatosplanchnic blood flow and the suprahepatic venous blood oxygen saturation (r 2 = .56; p
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Monitoring Gastric mucosal carbon dioxide pressure using gas Tonometry: in vitro and in vivo validation studies.
Anesthesiology, 1997Co-Authors: Jacques Creteur, Daniel De Backer, Jean Louis VincentAbstract:BackgroundSaline Gastric Tonometry of carbon dioxide has been proposed as a means to assess the adequacy of splanchnic perfusion. However, this technique has several disadvantages, including the long time interval needed for gases to reach equilibrium in saline milieu. Thus the authors evaluated a s
