Intramukosale pCO2-Tonometrie des Magens als Prognosefaktor für das Überleben von kardiologischen Intensivpatienten mit beatmungspflichtiger Linksherzdekompensation bzw. kardiogenem Schock

Introduction:The gastrointestinal tract plays a pivotal role in the pathogenesis of trauma, shock, systemic inflammatory syndrome (SIRS) and sepsis. Gastric tonometry is a low invasive monitoring technique assessing gastric prCO2 and CO2-gap, thus providing an integrative indicator for the perfusion, oxygenation and cellular energy metabolism of the gastrointestinal tract. Several studies proved the value of both parameters as predictors of mortality and morbidity in critically ill patients. Aim of this prospective study was to assess the value of prCO2 and CO2-gap as outcome predictors in critically ill patients with highly reduced left ventricular function needing mechanical ventilation. Methods: In 17 patients +AFs-64+-/-13 years, 12 male, APACHE III 71+-/-12, ejection fraction 24+-/-7+ACUAXQ- prCO2 and CO2-gap were assessed with a gastric tonometry catheter from time points T 0 (admission) to T 9 (64 hours after admission). Comparisons between survirors and non-survivors were performed with the Mann-Whitney U test. To compare changes over multiple time points, repeated - measures analysis of variance was used (ANOVA). Results: 8 patients died (47+ACU-). During the first 24 hours after study begin there was a rise in prCO2 from 44,5+-/-20,9 to 56,3+-/-12,6 mmHg and CO2-gap from 5,5+-/-16,2 to 20,4+-/-13,4 in all patients. This change showed no statistical significance with regard to the disrimination between survivors and non-survivors. At the end of the study both parameters had returned almost to their initial values. Conclusion: Neither prCO2 nor CO2-gap were able to discriminate between survivors and non-survivors in the patients examined and therefore gastric tonometry can not be used as prognostic value in these patients.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2002

Author dc:creator

• Karassimos, Evagelos

Contributors dc:contributor

• Hanrath, Peter

• info:eu-repo/classification/ddc/610
• Medizin

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-119140%22

OAI identifier oai:identifier

oai:publications.rwth-aachen.de:57071