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Letters |1 March 1994

Weaning Patients from Mechanical Ventilation Using Gastric pH

Dudley F. Rochester, MD

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Author, Article, and Disclosure Information
  • University of Virginia Health Schiences Center; Charlottesville, VA 22908
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TO THE EDITOR:
Mohsenifar and colleagues [1] reported that tissue acidosis, as reflected by a very low gastric intramural pH, accurately predicted failure to wean patients from mechanical ventilation.
The authors used the HCO3, PCO2, and pH from arterial blood gas analysis plus gastric PCO2 (PgCO2) and the PCO2 factor in the Henderson-Hasselbach equation to calculate gastric intramural pH [1]. Substitution and rearrangement permit cancellation of the HCO3 and PCO2 factor terms. The simpler revised formula is: gastric intramural pH = arterial pH − log(Pg CO2/PaCO2).
Both before and during weaning, arterial pH and PaCO2 were virtually identical in the weaning success and failure groups [1]. Because gastric PCO2 is the principal determinant of gastric intramural pH, would prediction of weaning outcome be as accurate using Pg CO2 alone? What are the sources of error in measuring gastric PCO2? What effect does hypotension or low cardiac output have on gastric PCO2, independent of weaning?
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Rochester DF. Weaning Patients from Mechanical Ventilation Using Gastric pH. Ann Intern Med. ;120:438–439. doi: 10.7326/0003-4819-120-5-199403010-00020

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Published: Ann Intern Med. 1994;120(5):438-439.

DOI: 10.7326/0003-4819-120-5-199403010-00020

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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