Equivalence of litmus paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit

R. L. Levine, R. E. Fromm, M. Mojtahedzadeh, A. A. Baghaie, A. R. Opekun

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To compare the accuracy of litmus paper-determined gastric pH to a nasogastric graphite antimony pH probe. Design: A prospective clinical trial of gastric pH determination in patients enrolled in a study of histamine-2-receptor (H2) antagonists. Setting: The medical intensive care unit (ICU) of a 450-bed county hospital. Patients: Critically ill ICU patients requiring stress ulcer prophylaxis. Interventions: Using a crossover design, the patients were randomized to initially receive an H2 antagonist by continuous infusion or intravenous bolus, and subsequently were crossed over to the other limb of the study. Measurements and Main Results: Gastric pH was determined using pH-sensitive litmus paper at the initiation of each limb of the study and at 1, 2, 4, and 8 hrs after the initiation of H2 receptor antagonist therapy. In addition, gastric pH was continuously determined over the same time period utilizing a graphite antimony pH probe. Gastric pH measurements determined with litmus paper and intragastric pH probes demonstrated an excellent correlation (r2 = .93, p < .001). McNemar's test of correlated proportions could not demonstrate a significant difference between the two monitoring methods (chi-square = 0.5, p > .47), and the kappa statistic (0.95, p < .001) demonstrated excellent concordance. Bias measurement was 0.01 (95% confidence interval = -0.155 to 0.176). Conclusions: Measurement of intragastric pH, using pH-sensitive litmus paper, is both sensitive and specific when utilizing a graphite antimony nasogastric pH probe as a reference standard. Litmus paper-determined gastric pH testing is both easy to perform and inexpensive. Therefore, based on the current data, we believe this technique (i.e., litmus paper determined gastric pH testing) to be the method of choice for determination of intragastric pH in patients at risk for stress gastric ulcers in the medical ICU.

Original languageEnglish
Pages (from-to)945-948
Number of pages4
JournalCritical Care Medicine
Volume22
Issue number6
StatePublished - Jan 1 1994

Fingerprint

Intensive Care Units
Stomach
Antimony
Histamine Receptors
Graphite
Extremities
County Hospitals
Stomach Ulcer
Intravenous Infusions
Critical Illness
Cross-Over Studies
Ulcer
Clinical Trials
Confidence Intervals

Keywords

  • abdominal emergencies
  • critical illness
  • gastric pH
  • gastrointestinal hemorrhage
  • histamine-2-receptor antagonist
  • intensive care unit
  • litmus paper
  • monitoring, physiologic
  • stress ulcer

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Levine, R. L., Fromm, R. E., Mojtahedzadeh, M., Baghaie, A. A., & Opekun, A. R. (1994). Equivalence of litmus paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit. Critical Care Medicine, 22(6), 945-948.

Equivalence of litmus paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit. / Levine, R. L.; Fromm, R. E.; Mojtahedzadeh, M.; Baghaie, A. A.; Opekun, A. R.

In: Critical Care Medicine, Vol. 22, No. 6, 01.01.1994, p. 945-948.

Research output: Contribution to journalArticle

Levine, RL, Fromm, RE, Mojtahedzadeh, M, Baghaie, AA & Opekun, AR 1994, 'Equivalence of litmus paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit', Critical Care Medicine, vol. 22, no. 6, pp. 945-948.
Levine RL, Fromm RE, Mojtahedzadeh M, Baghaie AA, Opekun AR. Equivalence of litmus paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit. Critical Care Medicine. 1994 Jan 1;22(6):945-948.
Levine, R. L. ; Fromm, R. E. ; Mojtahedzadeh, M. ; Baghaie, A. A. ; Opekun, A. R. / Equivalence of litmus paper and intragastric pH probes for intragastric pH monitoring in the intensive care unit. In: Critical Care Medicine. 1994 ; Vol. 22, No. 6. pp. 945-948.
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abstract = "Objective: To compare the accuracy of litmus paper-determined gastric pH to a nasogastric graphite antimony pH probe. Design: A prospective clinical trial of gastric pH determination in patients enrolled in a study of histamine-2-receptor (H2) antagonists. Setting: The medical intensive care unit (ICU) of a 450-bed county hospital. Patients: Critically ill ICU patients requiring stress ulcer prophylaxis. Interventions: Using a crossover design, the patients were randomized to initially receive an H2 antagonist by continuous infusion or intravenous bolus, and subsequently were crossed over to the other limb of the study. Measurements and Main Results: Gastric pH was determined using pH-sensitive litmus paper at the initiation of each limb of the study and at 1, 2, 4, and 8 hrs after the initiation of H2 receptor antagonist therapy. In addition, gastric pH was continuously determined over the same time period utilizing a graphite antimony pH probe. Gastric pH measurements determined with litmus paper and intragastric pH probes demonstrated an excellent correlation (r2 = .93, p < .001). McNemar's test of correlated proportions could not demonstrate a significant difference between the two monitoring methods (chi-square = 0.5, p > .47), and the kappa statistic (0.95, p < .001) demonstrated excellent concordance. Bias measurement was 0.01 (95{\%} confidence interval = -0.155 to 0.176). Conclusions: Measurement of intragastric pH, using pH-sensitive litmus paper, is both sensitive and specific when utilizing a graphite antimony nasogastric pH probe as a reference standard. Litmus paper-determined gastric pH testing is both easy to perform and inexpensive. Therefore, based on the current data, we believe this technique (i.e., litmus paper determined gastric pH testing) to be the method of choice for determination of intragastric pH in patients at risk for stress gastric ulcers in the medical ICU.",
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AB - Objective: To compare the accuracy of litmus paper-determined gastric pH to a nasogastric graphite antimony pH probe. Design: A prospective clinical trial of gastric pH determination in patients enrolled in a study of histamine-2-receptor (H2) antagonists. Setting: The medical intensive care unit (ICU) of a 450-bed county hospital. Patients: Critically ill ICU patients requiring stress ulcer prophylaxis. Interventions: Using a crossover design, the patients were randomized to initially receive an H2 antagonist by continuous infusion or intravenous bolus, and subsequently were crossed over to the other limb of the study. Measurements and Main Results: Gastric pH was determined using pH-sensitive litmus paper at the initiation of each limb of the study and at 1, 2, 4, and 8 hrs after the initiation of H2 receptor antagonist therapy. In addition, gastric pH was continuously determined over the same time period utilizing a graphite antimony pH probe. Gastric pH measurements determined with litmus paper and intragastric pH probes demonstrated an excellent correlation (r2 = .93, p < .001). McNemar's test of correlated proportions could not demonstrate a significant difference between the two monitoring methods (chi-square = 0.5, p > .47), and the kappa statistic (0.95, p < .001) demonstrated excellent concordance. Bias measurement was 0.01 (95% confidence interval = -0.155 to 0.176). Conclusions: Measurement of intragastric pH, using pH-sensitive litmus paper, is both sensitive and specific when utilizing a graphite antimony nasogastric pH probe as a reference standard. Litmus paper-determined gastric pH testing is both easy to perform and inexpensive. Therefore, based on the current data, we believe this technique (i.e., litmus paper determined gastric pH testing) to be the method of choice for determination of intragastric pH in patients at risk for stress gastric ulcers in the medical ICU.

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KW - gastrointestinal hemorrhage

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KW - monitoring, physiologic

KW - stress ulcer

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