pH 试纸检测和 pH 液体检测与危重症患者胃液标准 pH 计的准确性比较：一项诊断准确性研究。

Accuracy of pH strip testing and pH liquid testing versus standard pH meter of gastric contents in critically ill patients: a diagnostic accuracy study.

机构信息

Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

出版信息

BMJ Open. 2024 Jul 16;14(7):e081830. doi: 10.1136/bmjopen-2023-081830.

DOI:10.1136/bmjopen-2023-081830

PMID:39013655

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11253741/

Abstract

OBJECTIVE

The utilisation of pH level measurements from gastric contents may indicate the preferred tip position of a nasogastric tube or monitor the efficacy of stress ulcer prophylaxis in critically ill patients. We aimed to determine the accuracy of pH strip (pHS) tests and pH liquid (pHL) tests compared with the standard pH meter (pHM).

DESIGN

Diagnostic accuracy study.

SETTING

Gastric contents from medically critically ill patients.

PARTICIPANTS

In total, 113 gastric samples were collected from 27 critically ill patients.

OUTCOME MEASURE

The level of pH measured by pHM, pHS and pHL.

RESULTS

The pH values measured by pHM, pHS and pHL were 5.83 (IQR 5.12-6.61), 5.50 (IQR 5.00-6.00) and 5.75 (IQR 5.25-6.25), respectively. The pHS test showed greater accuracy, exhibiting a more positive correlation with the standard pHM measurement than the pHL test, with Y=0.95X+0.56; rho=0.91, p<0.001, and Y=1.09X - 0.72; rho=0.75, p<0.001, respectively. However, the pHS test demonstrated less agreement with the pHM than the pHL test, with biases of -0.27 versus 0.18, respectively. Noticeably, a slight variation in pHL from the standard pH values was found when we measured gastric contents with a pH lower than 5.

CONCLUSION

Both the pHS and pHL methods were good options for measuring gastric pH in critically ill patients. However, it was advisable to find alternative approaches to the pHL testing method when anticipated gastric acidity levels fall below 5.

TRIAL REGISTRATION NUMBER

TCTR20220530004.

摘要

目的

胃内容物 pH 值的测量可指示鼻胃管的最佳尖端位置，或监测危重症患者应激性溃疡预防的效果。我们旨在确定 pH 试纸（pHS）和 pH 液体（pHL）测试与标准 pH 计（pHM）相比的准确性。

设计

诊断准确性研究。

设置

来自患有重病的患者的胃内容物。

参与者

共从 27 名危重症患者中收集了 113 个胃样本。

结果测量

pHM、pHS 和 pHL 测量的 pH 值。

结果

pHM、pHS 和 pHL 测量的 pH 值分别为 5.83（IQR 5.12-6.61）、5.50（IQR 5.00-6.00）和 5.75（IQR 5.25-6.25）。pHS 测试的准确性更高，与标准 pHM 测量的相关性比 pHL 测试更积极，分别为 Y=0.95X+0.56；rho=0.91，p<0.001 和 Y=1.09X - 0.72；rho=0.75，p<0.001。然而，pHS 测试与 pHM 的一致性不如 pHL 测试，偏差分别为-0.27 和 0.18。值得注意的是，当我们测量 pH 值低于 5 的胃内容物时，发现 pHL 与标准 pH 值略有差异。