SynthesisCritical care (London, England)2015
Gastric tonometry guided therapy in critical care patients: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 41 citations in OpenAlex.
- Physiologic Determinants of Near-Infrared Spectroscopy-Derived Cerebral and Tissue Oxygen Saturation Measurements in Critically Ill Patients.Critical care explorations · 2024Trial
- A review of gut failure as a cause and consequence of critical illness.Critical care (London, England) · 2025Review
- Restrictive versus goal-directed fluid replacement strategy in ovarian cancer cytoreductive surgery (RiGoROCS): A randomised controlled trial.Indian journal of anaesthesia · 2023Article
- Impairment of Mesenteric Perfusion as a Marker of Major Bleeding in Trauma Patients.Journal of clinical medicine · 2023Review
- Comparison of gastric reactance with commonly used perfusion markers in a swine hypovolemic shock model.Intensive care medicine experimental · 2022Article
- A Ratiometric Optical Dual Sensor for the Simultaneous Detection of Oxygen and Carbon Dioxide.Sensors (Basel, Switzerland) · 2021Article
- Effects of Pneumoperitoneum on Splanchnic Oxygenation during Abdominal Laparoscopic Surgery in Paediatric Patients: A prospective, Observational Study.Turkish journal of anaesthesiology and reanimation · 2021Article
- Diarrhoea in critical care is rarely infective in origin, associated with increased length of stay and higher mortality.Journal of the Intensive Care Society · 2020Article
- Quantitative Assessment of Blood Lactate in Shock: Measure of Hypoxia or Beneficial Energy Source.BioMed research international · 2020Review
- Relationship between Gastric pH Measurement and Intra-abdominal Pressure in Patients Undergoing Laparoscopic Surgery.Sisli Etfal Hastanesi tip bulteni · 2020Article
- An increase in heart rate variability can be an index for end point of resuscitation in trauma patients.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2019Article
- Current concepts of perioperative monitoring in high-risk surgical patients: a review.Patient safety in surgery · 2019Review
- Effects of dopamine, norepinephrine and dobutamine on gastric mucosal pH of septic shock patients.Experimental and therapeutic medicine · 2016Article
- Diarrhoea in the critically ill is common, associated with poor outcome, and rarely due to Clostridium difficile.Scientific reports · 2016Article
- Does gastric tonometry-guided therapy reduce total mortality in critically ill patients?Critical care (London, England) · 2015Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe value of gastric intramucosal pH (pHi) can be calculated from the tonometrically measured partial pressure of carbon dioxide ([Formula: see text]) in the stomach and the arterial bicarbonate content. Low pHi and increase of the difference between gastric mucosal and arterial [Formula: see text] ([Formula: see text] gap) reflect splanchnic hypoperfusion and are good indicators of poor prognosis. Some randomized controlled trials (RCTs) were performed based on the theory that normalizing the low pHi or [Formula: see text] gap could improve the outcomes of critical care patients. However, the conclusions of these RCTs were divergent. Therefore, we performed a systematic review and meta-analysis to assess the effects of this goal directed therapy on patient outcome in Intensive Care Units (ICUs).
methodsWe searched PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov for randomized controlled trials comparing gastric tonometry guided therapy with control groups. Baseline characteristics of each included RCT were extracted and displayed in a table. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes. Another measure of effect (risk difference, RD) was used to reassess the effects of gastric tonometry on total mortality. We performed sensitivity analysis for total mortality. Continuous outcomes were presented as standardised mean differences (SMDs) together with 95% CIs.
resultsThe gastric tonometry guided therapy significantly reduced total mortality (OR, 0.732; 95% CI, 0.536 to 0.999, P = 0.049; I(2) = 0%; RD, -0.056; 95% CI, -0.109 to -0.003, P = 0.038; I(2) = 0%) when compared with control groups. However, after excluding the patients with normal pHi on admission, the beneficial effects of this therapy did not exist (OR, 0.736; 95% CI 0.506 to 1.071, P = 0.109; I(2) = 0%). ICU length of stay, hospital length of stay and days intubated were not significantly improved by this therapy.
conclusionsIn critical care patients, gastric tonometry guided therapy can reduce total mortality. Patients with normal pHi on admission contributed to the ultimate result of this outcome; it may indicate that these patients may be more sensitive to this therapy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.