GASTRIC TONOMETRY IN PATIENTS WITH SEPSIS - EFFECTS OF DOBUTAMINE INFUSIONS AND PACKED RED-BLOOD-CELL TRANSFUSIONS

We wanted to determine the efficacy of dobutamine infusions and Prbc transfusions on splanchnic tissue oxygen utilization by measuring gastric pHi. Physiologic parameters and pHi measurements via the use of a gastric tonometer were obtained in 21 septic patients before and after the administration of a dobutamine infusion (5-mu-g/kg/min) or the transfusion of two units of Prbc. Subsets of measurements with normal (> 7.32) and with low (< 7.32) pHi were separately analyzed for each intervention. In the dobutamine low pHi group, pHi increased significantly from 7.16 +/- 0.03 to 7.24 +/- 0.03 (n = 9, p < 0.05). In contrast, pHi failed to increase in the Prbc low pHi subgroup (7.16 +/- 0.05 to 7.17 +/- 0.04 [n = 10, p > 0.80]). We conclude that dobutamine rather than Prbc transfusions should be administered to reverse gastric intramucosal acidosis.