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WO1998001070A1 - Procede de determination du ph dans la muqueuse de l'estomac ou dans le tractus gastro-intestinal - Google Patents

Procede de determination du ph dans la muqueuse de l'estomac ou dans le tractus gastro-intestinal Download PDF

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Publication number
WO1998001070A1
WO1998001070A1 PCT/NL1997/000397 NL9700397W WO9801070A1 WO 1998001070 A1 WO1998001070 A1 WO 1998001070A1 NL 9700397 W NL9700397 W NL 9700397W WO 9801070 A1 WO9801070 A1 WO 9801070A1
Authority
WO
WIPO (PCT)
Prior art keywords
carbon dioxide
stomach
gastrointestinal tract
factor
correction
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/NL1997/000397
Other languages
English (en)
Inventor
Johannes Louis Bams
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Academisch Ziekenhuis Groningen
Original Assignee
Academisch Ziekenhuis Groningen
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Academisch Ziekenhuis Groningen filed Critical Academisch Ziekenhuis Groningen
Priority to AU33616/97A priority Critical patent/AU3361697A/en
Publication of WO1998001070A1 publication Critical patent/WO1998001070A1/fr
Priority to US09/225,656 priority patent/US6125293A/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/14542—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue for measuring blood gases
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/14539—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue for measuring pH
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/1468—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using chemical or electrochemical methods, e.g. by polarographic means
    • A61B5/1473—Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using chemical or electrochemical methods, e.g. by polarographic means invasive, e.g. introduced into the body by a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222—Evaluating particular parts, e.g. particular organs
    • A61B5/4238—Evaluating particular parts, e.g. particular organs stomach

Definitions

  • the invention relates to a method of determining the intramucosal pH of an animal or human stomach or gastrointestinal tract, comprising the determination of the carbon dioxide tension in the arterial blood and the determination of a carbon dioxide tension in the blood flowing through the wall of the stomach or gastrointestinal tract, by introducing into the stomach preferably a tube with a balloon which is permeable only for carbon dioxide and which is filled with a saline solution, and after a previously determined retention time of at least 30 minutes, removing said balloon for analysis of the carbon dioxide fraction present in the saline solution.
  • pH of, for instance, a stomach wall is determined by the assumption that the partial carbon dioxide pressure in the surface layers of the stomach wall is in equilibrium with those of the deeper layers of the stomach wall.
  • a further assumption is that the bicarbonate concentration in the tissue is the same as the bicarbonate concentration in the arterial blood.
  • pHa and PaC0 2 in this formula relate to the arterial blood.
  • the formula is modified by replacing PaC0 2 with PiC0 2 , that is to say the carbon dioxide pressure in the stomach wall, and to assume as mentioned above, that the concentration of the bicarbonate in the tissue is in equilibrium with the bicarbonate concentra- tion in the arterial blood.
  • this latter assumption is not correct, particularly with patients who are critically ill and are in septic or anaphylactic shock.
  • the pH measured according to the known method deviates from the actual pH, thus hindering a correct and timely treatment of the patient.
  • measurement of the partial carbon dioxide pressure in the stomach is obtained by inserting a silicone balloon containing a saline solution into the gastrointestinal tract whereby the carbon dioxide pressure in the saline solution should equilibrate with the carbon dioxide pressure in the gastrointestinal tract. Then the time required to achieve equilibration is measured and the partial carbon dioxide pressure in the saline solution is determined using a blood gas analyzer while, if necessary, a nomogram is used for the determination of the stabilized carbon dioxide value, departing from the stabilisation time and the carbon dioxide pressure measured in the saline solution in combination with the bicarbonate concentration in a substantially simultaneously taken arterial blood sample.
  • WO 94/21163 suggests to compare the carbon dioxide pressure relating to the respective organ with the arterial bicarbonate concentration and/or another direct or indirect measurement of a global or systematic physiologic value, such as the pH, the carbon dioxide pressure or oxygen pressure of arterial, venous or other kind of blood, mixed venous bicarbonate, the carbon dioxide pressure in the exhalation air or other values and, in order to determine whether the condition of the respective organ renders it desirable that a) a bicarbonate concentration should be determined and/or b) what kind of clinical therapy or interference is necessary or desirable with regard to the oxygen supply to the respective organ.
  • a global or systematic physiologic value such as the pH, the carbon dioxide pressure or oxygen pressure of arterial, venous or other kind of blood, mixed venous bicarbonate, the carbon dioxide pressure in the exhalation air or other values
  • the respiration rhythm is adjusted to maintain a partial carbon dioxide pressure of 40 ⁇ 5 Torr.
  • the animals are kept on a core body temperature of
  • Blood samples were taken from a femoral artery. After the placement of several catheters an abdominal incision is made and a tube is inserted into the right carotid for bleeding the animal. A needle probe is placed in the sto- mach wall for measuring the direct pH value, and the abdominal incision is covered with blankets to prevent dehydration. The animals are then left in peace for 60 min. to stabilize. A tube is placed in the stomach for measuring the partial carbon dioxide tension. The needle probe used is calibrated with buffer solutions which calibration is repeated after each experiment in order to determine the stability of the probe .
  • the measuring protocol proceeded as follows :

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Optics & Photonics (AREA)
  • Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Endocrinology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Physiology (AREA)
  • Investigating Or Analysing Biological Materials (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

Le procédé de l'invention consiste à déterminer la tension de l'anhydride carbonique dans la paroi de l'estomac ou du tractus gastro-intestinal, par insertion, dans l'estomac, d'un ballonnet semi-perméable rempli d'une solution saline. Le procédé consiste ensuite à multiplier par un facteur de correction le résultat obtenu à partir de l'analyse de la fraction d'anhydride carbonique contenue dans la solution saline, afin d'obtenir une valeur mesurée stabilisée de la fraction d'anhydride carbonique se rapportant au sang circulant à travers la paroi de l'estomac ou du tractus gastro-intestinal, laquelle valeur stabilisée correspond à une fraction d'anhydride carbonique mesurée et appartenant à une durée de rétention d'un heure ou plus, puis à multiplier, d'une part, la tension d'anhydride carbonique PaCO2 du sang artériel par un premier facteur F pour obtenir un premier produit de correction, et d'autre part la tension d'anhydride carbonique PiCO2 du sang circulant à travers la paroi de l'estomac ou du tractus gastro-intestinal par un second facteur F0 pour obtenir un second produit de correction, puis à ajouter le premier produit de correction à un facteur de base F et à soustraire le second produit de celui-ci, selon la formule: pHi = F0 + F1 * PaCO2 - F2 * PiCO2, dans laquelle pHi constitue une mesure du pH de l'estomac ou du tractus gastro-intestinal.
PCT/NL1997/000397 1996-07-08 1997-07-08 Procede de determination du ph dans la muqueuse de l'estomac ou dans le tractus gastro-intestinal Ceased WO1998001070A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU33616/97A AU3361697A (en) 1996-07-08 1997-07-08 Method for determining the ph in the mucosa of the stomach or the gastrointestinal tract
US09/225,656 US6125293A (en) 1996-07-08 1999-01-05 Method for determining the pH in the mucosa of the stomach or the gastrointestinal tract

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL1003533A NL1003533C2 (nl) 1996-07-08 1996-07-08 Werkwijze voor het bepalen van de zuurgraad in het slijmvlies van de maag of van het maagdarmkanaal.
NL1003533 1996-07-08

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US09/225,656 Continuation US6125293A (en) 1996-07-08 1999-01-05 Method for determining the pH in the mucosa of the stomach or the gastrointestinal tract

Publications (1)

Publication Number Publication Date
WO1998001070A1 true WO1998001070A1 (fr) 1998-01-15

Family

ID=19763164

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/NL1997/000397 Ceased WO1998001070A1 (fr) 1996-07-08 1997-07-08 Procede de determination du ph dans la muqueuse de l'estomac ou dans le tractus gastro-intestinal

Country Status (3)

Country Link
AU (1) AU3361697A (fr)
NL (1) NL1003533C2 (fr)
WO (1) WO1998001070A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6462681B1 (en) 1999-08-27 2002-10-08 Koninklijke Philips Electronics N. V. Scalable coding by scanning selected parts of respective bit-streams
WO2010125215A1 (fr) * 2009-04-29 2010-11-04 Munoz Bonet Juan Ignacio Système de mesure, d'enregistrement et de surveillance en continu de la perfusion tissulaire splénique et de l'espace mort pulmonaire physiologique, et son utilisation

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0089647A2 (fr) * 1982-03-22 1983-09-28 FIDDIAN-GREEN, Richard G. Tonométrie de viscères creuses
WO1990001893A1 (fr) * 1988-08-26 1990-03-08 Mountpelier Investments S.A. Procede et appareil a catheter tonometrique de detection a distance
WO1994021163A1 (fr) * 1993-03-22 1994-09-29 Instrumentarium Corporation Dispositif et procede concernant un catheter tonometrique de detection a distance

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0089647A2 (fr) * 1982-03-22 1983-09-28 FIDDIAN-GREEN, Richard G. Tonométrie de viscères creuses
WO1990001893A1 (fr) * 1988-08-26 1990-03-08 Mountpelier Investments S.A. Procede et appareil a catheter tonometrique de detection a distance
WO1994021163A1 (fr) * 1993-03-22 1994-09-29 Instrumentarium Corporation Dispositif et procede concernant un catheter tonometrique de detection a distance

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6462681B1 (en) 1999-08-27 2002-10-08 Koninklijke Philips Electronics N. V. Scalable coding by scanning selected parts of respective bit-streams
WO2010125215A1 (fr) * 2009-04-29 2010-11-04 Munoz Bonet Juan Ignacio Système de mesure, d'enregistrement et de surveillance en continu de la perfusion tissulaire splénique et de l'espace mort pulmonaire physiologique, et son utilisation
ES2379817A1 (es) * 2009-04-29 2012-05-04 Juan Ignacio Muñoz Bonet Sistema para la medición, registro y monitorización continua de la perfusión tisular esplácnica y el espacio muerto fisiológico pulmonar, y su uso.
US9730614B2 (en) 2009-04-29 2017-08-15 Juan Ignacio Muñoz Bonet System for continuous measuring, recording and monitoring of the splanchnic tissue perfusion and the pulmonary physiological dead space, and use thereof

Also Published As

Publication number Publication date
AU3361697A (en) 1998-02-02
NL1003533C2 (nl) 1998-01-12

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