The assessment of visceral perfusion using gastric tonometry, for risk of acute gastric ulcer in patients undergoing vascular surgery around the aorta

Aim : To assess visceral perfusion using gastric tonometry in patients undergoing major vascular surgery on the aorta.

Material and methods : Intraoperative tonometry was performed on 14 patients included in the study. pHi, PrCO2, GAP, and end-expiratory GAP were measured before clamping the aorta (time point number 1), during the clamping after haemodynamic parameters were stabilized (time point number 2), and after declamping and haemodynamic stabilization (time point number 3).

Results : Mean pHi values were: time point number 1: 7.4621 (range 7.36-7.68); time point number 2: 7.3752 (range 7.33-7.42), time point number 3: 7.30785 (range 7.21-7.39). Mean PrCO2 values were: time point number 1: 39.28571 (range 21-54), time point number 2: 45.142 (range 23-59), time point number 3: 48.28571 (range 39-59). Mean GAP values were: time point number 1: –1.57143 (range –22.0 +18.00); time point number 2: 4.71429 (range –11.0 +18.00), time point number 3: 5.07143 (range –8.0 +14.0). Mean end-expiratory GAP values were: time point number 1: 9.07143 (mean –7.0 +30.0); time point number 2: 13.28571 (range 6.0 +31.0); time point number 3: 14.07143 (range –1 +21). The differences between the analysed groups were statistically significant.

Conclusions : Gastric tonometry allows detection of visceral perfusion impairment in patients undergoing reconstructive surgery of the abdominal aorta. Intraoperative tonometry may be helpful for adequate fluid resuscitation and choice of appropriate type of anaesthesia.