Effect of dopexamine on calculated low gastric intramucosal pH following valve replacement

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Abstract
Gastric tonometry was used to study the possible effect of dopexamine infusion on a low calculated intramucosal pH (pHi) as a sign of splanchnic ischemia.Measurements were made during surgery and for approximately 18 hours postoperatively on 19 non‐selected adult patients undergoing valve replacement. Patients developing a postoperative pHi>7.30 were randomized to receive dopexamine (2 μg · kg‐1min‐1) or placebo in a double blind fashion. Eighteen patients wore randomized, 10 to receive dopexamine and 8 to placebo.The calculated pHiremained unchanged for the first 2 hours in both groups. After 4 hours a significant (P0.12 occurred more often than in those without complications, indicating that an increased incidence of complications was related to a pH‐gap >0.12.It is our opinion that true mucosal ischemia is best detected by estimating the difference in carbon dioxide tension between arterial blood and mucosa. This can be expressed either directly as PCO2‐gap (PtonCO2‐PaCO2) or indirectly as pH‐gap.