Document Detail


Effects of feeding on gastric tonometric measurements in critically ill children.
MedLine Citation:
PMID:  14707587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of gastric feeding on the measurement of gastric intramucosal PCO2 (PiCO2) and its derived gastric intramucosal PCO2-arterial PCO2 difference (PiCO2-PaCO2 difference) and gastric intramucosal pH (pHi) in a group of critically ill children using recirculating gas tonometry. DESIGN: Prospective clinical pilot study. SETTING: Sixteen bed pediatric intensive care unit. PATIENTS: Ten mechanically ventilated and hemodynamically stable children (median age, 20.1 months [interquartile range (IQR), 9.7-47.6 months] and median weight, 10.2 kg [IQR, 10-16.5 kg]). INTERVENTIONS: A 7-French recirculating gas tonometer was placed in the stomach via the orogastric route. MEASUREMENTS: In each patient, baseline fasted/unfed PiCO2, PiCO2-PaCO2 difference, and pHi were determined hourly over a 5-hr period. Gastric feeding was then reestablished (3 mL/kg/hr) within a median time of 3 hrs and a further 5 hourly measurements were determined. Concurrent arterial blood gas and lactate measurements were taken. Blood pressure and heart rate was monitored throughout. MAIN RESULTS: Hemodynamic parameters remained stable throughout the study period. When compared with the unfed/fasting state, PiCO2 measurements and PiCO2-PaCO2 difference were consistently lower and pHi values higher than when the patients were fed (two-way analysis of variance for repeated measures: all p <.001 between groups). Measurements did not vary over time. CONCLUSIONS: In our patient group, gastric feeding decreased the PiCO2 and PiCO2-PaCO2 difference and increased pHi compared with the unfed state. These findings are in contrast to those found in adult studies.
Authors:
Kentigern Thorburn; Andrew Durward; Shane M Tibby; Ian A Murdoch
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  32     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-06     Completed Date:  2004-02-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Intensive Care, Royal Liverpool Children's Hospital-Alder Hey, UK.
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MeSH Terms
Descriptor/Qualifier:
Blood Gas Analysis
Carbon Dioxide / analysis,  metabolism*
Child, Preschool
Critical Care / methods
Critical Illness / therapy*
Enteral Nutrition / methods*
Female
Gastric Emptying / physiology*
Gastric Mucosa / blood supply
Gastrostomy
Humans
Hydrogen-Ion Concentration
Infant
Intensive Care Units, Pediatric
Male
Manometry / methods
Monitoring, Physiologic / instrumentation*
Multivariate Analysis
Pilot Projects
Probability
Prognosis
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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