Effect of nasogastric suction and ranitidine on the calculated gastric intramucosal pH

Objective. To study the effect of nasogastric suction and ranitidine on the determination of gastric intramucosal pH (pH(i)). Design: Prospective study. Setting.. Clinical research unit at a university hospital intensive care department. Subjects. 12 healthy volunteers. Interventions: After a 2-h measurement control period a tonometer was connected to nasogastric suction for 2 h, and thereafter ranitidine was given intravenously and gastric pH(i) measured. Measurements and results: During each 2-h measurement period gastric PCO2, gastric pH(i), and pH gap were determined every 30 min. Luminal pH was measured after insertion of tonometer and at the end of each study period. Neither nasogastric suction nor ranitidine had an effect on the coefficient of variation for either gastric PCO2 or pH(i). Compared to control and nasogastric suction periods, after ranitidine mean gastric pH(i) was higher (control 7.22 +/- 0.08; nasogastric suction 7.23 +/- 0.07; after ranitidine 7.31 +/- 0.06: p < 0.001) mean gastric PCO2 lower (control 6.4 +/- 1.3; nasogastric suction 6.5 +/- 1.3; after ranitidine 5.3 +/- 0.9, p < 0.001) and pH gap lower (control 0.18 +/- 0.08; nasogastric suction 0.17 +/- 0.05, after ranitidine 0.09 +/- 0.06, p (-0.01). Luminal pH increased after ranitidine in each subject. Conclusions: H-2 blockers have no effect on the reproducibility of gastric pH(i) measurements, but the use of H-2 blockers modifies the normal values for gastric pH(i) in healthy subjects.