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- W2014282743 abstract "Letters1 March 1994Weaning Patients from Mechanical Ventilation Using Gastric pHZ. Mohsenifar, MD, Spencer K. Koerner, MD, and Michael I. Lewis, MDZ. Mohsenifar, MDCedars-Sinai Medical Center; Los Angeles, CA 90048Search for more papers by this author, Spencer K. Koerner, MDCedars-Sinai Medical Center; Los Angeles, CA 90048Search for more papers by this author, and Michael I. Lewis, MDCedars-Sinai Medical Center; Los Angeles, CA 90048Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-5-199403010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Rochester raises several interesting questions and makes many insightful comments. Gastric PCO2 is the main determinant of gastric intramural pH. As we stated [1], a rising gastric PCO2 would have predicted 9 of 11 weaning failures and an elevated baseline gastric PCO2 would have predicted the remaining 2 failures. Independent of weaning, hypotension or low cardiac states would be expected to be detrimental to splanchnic blood flow, which would eventually result in a rise in gastric CO2. Dead space in the nasogastric tube and bicarbonate flux are possible sources of error in measuring real-time gastric PCO2.We ...References1. Mohsenifar Z, Hay A, Hay J, Lewis MI, Koerner SK. Gastric intramural pH as a predictor of success or failure in weaning patients from mechanical ventilation. Ann Intern Med. 1993; 119:794-8. Google Scholar2. Magder S, Erian R, Roussos C. Respiratory muscle blood flow in oleic acid-induced pulmonary edema. J Appl Physiol. 1986; 6:1849-56. Google Scholar3. Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med. 1991; 324:1445-50. Google Scholar4. Lee KH, Hui KP, Chan TB, Tan WC, Lim TK. Frequency/tidal volume ratio did not predict extubation outcome (Abstract). Am Rev Respir Dis. 1993; 147:A873. Google Scholar5. Nathan SD, Ishaaya AM, Koerner SK, Belman MJ. Prediction of minimal presure support during weaning from mechanical ventilation. Chest. 1993; 103:1215-9. Google Scholar6. Fiastro JF, Habib MP, Quan SF. Pressure support compensation for inspiratory work due to endotracheal tubes and demand for continuous positive airway pressure. Chest. 1988; 93:499-505. Google Scholar Author, Article, and Disclosure InformationAffiliations: Cedars-Sinai Medical Center; Los Angeles, CA 90048 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySevere Hyperkalemia in a Geriatric Patient Receiving Standard Doses of Trimethoprim-Sulfamethoxazole 1 March 1994Volume 120, Issue 5Page: 438-439KeywordsBlood flowBreathingExtubationFraction of inspired oxygenHypotensionMusclesRunningTidal volumeVentilatorsWeaning ePublished: 15 August 2000 Issue Published: 1 March 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ..." @default.
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- W2014282743 title "Weaning Patients from Mechanical Ventilation Using Gastric pH" @default.
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