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CRITICAL CARE AND TRAUMA

Metabolic Acidosis and Respiratory Acidosis Impair Gastro-Pyloric Motility in Anesthetized Pigs

Jean Pierre Tournadre, MD^*, Bernard Allaouchiche, MD^*, Charles Henri Malbert, PhD, and Dominique Chassard, MD, PhD^*

*Critical Care Division, Hôpital de l’Hôtel-Dieu, Lyon; and Institut National pour la Recherche Agronomique (INRA), Saint-Gilles, Rennes, France

Address correspondance and reprint requests to Dr. D. Chassard, Département d’Anesthésie-Réanimation, Hôpital de l’Hôtel-Dieu, 69002 Lyon, France. Address e-mail to jean-pierre.tournadre{at}chu-lyon.fr

Acidosis impairs smooth muscle function in various organs. However, the effects of acidosis on the gastroduodenal tract are unknown while its dysfunction has potential perioperative harmful consequences. We investigated the effects of metabolic (MA) and respiratory acidosis (RA) on upper gut motility in tracheally ventilated pigs whose anesthesia was induced with halothane and maintained with -chloralose-urethane administration (IV). Increased dead space and perfusion of hydrochloric acid 1 N (150 mL over 30 min) were used to induce RA and MA, respectively. Measurements of fundic tone using an electronic barostat, antro-pyloroduodenal phasic motility with perfused manometry and antro-duodenal electric control activity by electromyography were used to evaluate gastro-duodenal function. Acidosis increased the fundic tone as reflected by a decrease in barostat volumes from 275 ± 83 to 194 ± 88 mL for MA and from 278 ± 93 to 236 ± 106 mL for RA. Pyloric and duodenal basal tones were not affected by either acidosis. A decrease in pyloric contraction amplitude from 95 ± 24 to 62 ± 26 mm Hg during MA and from 94 ± 26 to 64 ± 20 mm Hg during RA was observed. Both acidosis altered antral control activity that became dysrhythmic. Acidosis could be implicated in perioperative complications, such as gastroparesis, emesis, and regurgitation of gastric contents.

Implications: Metabolic and respiratory acidosis mainly affects gastric antral rhythms and has a major effect on fundic tone. Acidosis could be implicated in perioperative complications, such as gastroparesis, emesis, and regurgitation of gastric contents.

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