pH, where p is power and H is hydrogen- power of hydrogen is very crucial for body's homeostasis and normal functioning.
pH monitoring is very important in a critically ill patient, in todays world we heavily rely on arterial blood gases (ABG). But ABGs are drawn hours apart and in the mean time crucial hours can be lost.
I think we we can monitor the pH on a continuous way as we do other vitals - it can save more lives. What do you all think ?
Article Clinical evaluation of a multiparameter intra-arterial blood...
Article Equipment review: Continuous assessment of arterial blood gases
https://www.cicm.org.au/CICM_Media/CICMSite/CICM-Website/Resources/Publications/CCR%20Journal/Previous%20Editions/June%201999/05-Jun_1999_Continuous-Intra-arterial.pdf
https://doi.org/10.1177%2F0267659117702710
These might be of use to you....there's been a lot of research(even back to when I was training!)but relatively few manufacturers,e.g. Terumo but the few i can currently find are aimed purely at cardiopulmonary bypass.
There are always the risks of thrombosis,infection,disconnection etc plus calibration.
Thank you!
I know it's not a lot to go on,and perhaps even less help but we now use the Edwards non-invasive haemodynamics kit,and rely on serial ABG analysis on an ABG analyser in the ITU.
For the most part it works well,and I think that it provides reasonably quick response times to changes,but there is little doubt in my mind that accurate trend data are even more useful in many cases.
Being able to see pH changes in real time offers a real insight into whether or not your treatment is working.
We don't have such monitoring devices in the pediatric ICU settings, though we repeat blood gases frequently for few patients.
in the late 90s I had some clinical measurements with a system enabling continuous pH- and blood gas measurements. It came from England. It was very useful, nothertheless it was withdrawn from the market because of high price and not enough clinical appropriateness. It was very fascinating for the research, nethertheless, too expensive for the clinical practice. I have not heard of it since that time. It`s really sad.
Thanks @János Juhász for enlightening us about this.
As older technologies usually become cheaper with time, I wonder if this may facilitate a "come back" of such clinical tools.
Integrated into automated ICU monitoring system seems theoretically useful .
Dear @Russell Schmidt,
Seems this technique is far from waveform capnography.
However, I think it can become a very important supplemental monitor for our ventilated ICU patients. For example, a child on HFOV that is not compatible with end tidal CO2 capnography, who may suddenly have increased pCO2 for whatever reason. If such patient was on continuous pH monitoring, it would be picked up and addressed much earlier..
What is the goal? CO2 indicates ventilatory status and should be monitored non-invasively, if possible. If your patient is on HFOV they have an oxygenation issue (e.g.; RDS, PPHN) and are probably in permissive hypercapnia, anyway. Sounds good but, is it worth the risk of infection?
no James, unfortunately not. I tried already to recall the name but I can not get it. I decided to reserach in my old documents, I guess, wether I could find something.
I will let you know.
Following. This would be a great tool. The best we can do right now is monitor continuous CO2 on intubated patients, which can at least guide our estimation of the direction our Ph is going from a respiratory standpoint. However, for metabolic acidosis......
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