Risk factors for bleeding from stress ulcerations:
(1) admission to the ICU for post-operative care, burn, major trauma, or myocardial infarction
(2) established liver disease with total bilirubin > 0.9 mg/dL
(3) renal disease with a serum creatinine > 1.3 mg/dL
(4) respiratory failure requiring mechanical ventilation
(5) definite evidence of sepsis
(6) systemic hypotension with systolic blood pressure < 80 mm Hg
Models:
(1) based on intramural pH (measured using a pH probe) and number of risk factors
(2) gastric juice pCO2 in mm Hg
(3) arterial bicarbonate in mEq/L
Parameters defined for each model (Table 2, page 616):
(1) µ expression
(2) critical value
In general, the models consisted of:
X =
= (critical value) - (µ expression)
Y = probability of not massively bleeding =
= 1 / (1 + EXP((-1) * X))
probability of massive bleeding =
= 1 - Y
|
Model
|
Critical Value
|
µ Expression
|
|
pH and risk factors
|
-9.93
|
(1.05 * ((number of risk factors) + 1)) - (2.27 * (intramural pH))
|
|
gastric juice pCO2
|
3.69
|
0.0146 * pCO2
|
|
arterial bicarbonate
|
0.058
|
-0.099 * (arterial bicarbonate)
|
from Table 2, Figure 3 and Figure 4
