Operations that require supracoeliac aortic cross-clamping: Perioperative monitoring with gastric tonometry

Objective: To assess the predictive value of a gastric intramucosal pH of less than 7.35 for mortality in surgical patients after supracoeliac aortic cross-clamping. Design: Open prospective clinical study. Setting: University hospital, The Netherlands. Subjects: Six patients who required temporary supracoeliac, and four patients who required temporary infrarenal, cross-clamping of the aorta. Main outcome measures: Mortality and conventional measures of organ dysfunction correlated with gastric tonometry. Results: All 6 patients who required supracoeliac cross-clamping underwent a steep, and 5 patients a prolonged, decrease in the gastric intramucosal pH. The mean lowest gastric intramucosal pH in the supracoeliac group was 7.05 and in the infrarenal group 7.28. All patients recovered completely. Conclusion: A pHig value below 7.35 does not seem to be a marker of mortality in patients who have undergone supracoeliac cross-clamping of the aorta.