| Objective. To assess the relationship between the duration of gastric mucosal acidosis and the development of sepsis and multiple organ failure (MOF). Length of ICU stay, hospital stay, and hospital mortality were also recorded.;Design. Prospective comparison of outcome.;Setting. General adult ICU in a teaching hospital.;Patients. 48 consecutive critically ill patients with a predicted ICU stay ;Interventions. Gastric tonometers were placed in all patients and gastric intramucosal pH was measured at admission, 2 hrs, 4 hrs, 6 hrs, 12 hrs, 24 hrs, 36 hrs, and 48 hrs.;Main outcome measures. Organ system failure (OSF) scores, septic severity scores (SSS), length of hospital and ICU stays, and mortality were assessed.;Results. 26 of the 48 patients (54%) had mucosal acidosis at some point during the first 48 hours. Patients with gastric mucosal acidosis had higher OSF, SSS scores, and longer ICU stays compared to patients without acidosis. The duration of acidosis was strongly correlated with the OSF score and to the SSS. Patients with a longer duration of gastric mucosal acidosis were also more likely to die (p ;Conclusions. Critically ill patients with gastric mucosal acidosis are at increased risk for the development of sepsis and organ failure and tend to have longer ICU and hospital stays. Hospital mortality is increased in those patients with a longer duration of acidosis. Gastric tonometry is useful in predicting the development of MOF in critically ill patients. (Abstract shortened by UMI.). |
