Yee J B, McJames S W
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City.
Circ Shock. 1994 May;43(1):44-8.
During resuscitation of the patient suffering from hemorrhagic shock, it may be difficult to determine the adequacy of treatment in the acute setting. The objective of these preliminary studies was to determine if monitoring perfusion of the gastrointestinal tract as estimated by gastric intramucosal pH (pHi) is useful as a guide during the treatment of hemorrhagic shock. Dogs were bled using a modified Wigger's method to a mean arterial blood pressure of 50 mmHg, and pHi was determined 30, 60, 90, and 120 min later. Gastric intramucosal acidosis developed within 30 min of induction of hemorrhagic shock. It was also found that pHi decreases with relatively small amounts of blood loss. There was a significant fall in pHi following hemorrhage to a mean arterial pressure of 80 mmHg from a baseline pressure of 100 mmHg. Following the reinfusion of shed blood, the pHi returned to baseline values within 30 min. It is concluded that measurements of pHi may be a useful monitor in the evaluation and initial resuscitation of patients in hemorrhagic shock.
在对失血性休克患者进行复苏时，在急性情况下可能难以确定治疗是否充分。这些初步研究的目的是确定通过胃黏膜内pH值（pHi）评估的胃肠道灌注监测在失血性休克治疗过程中是否可作为一种指导。使用改良的维格氏方法将狗放血至平均动脉血压为50 mmHg，并在30、60、90和120分钟后测定pHi。失血性休克诱导后30分钟内出现胃黏膜酸中毒。还发现pHi随相对少量的失血而降低。从基线血压100 mmHg出血至平均动脉压80 mmHg后，pHi显著下降。回输失血后，pHi在30分钟内恢复到基线值。结论是，pHi测量可能是评估和初步复苏失血性休克患者的有用监测指标。
