| Effects of feeding on gastric tonometric measurements in critically ill children. | |
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MedLine Citation:
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PMID: 14707587 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kentigern Thorburn; Andrew Durward; Shane M Tibby; Ian A Murdoch |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 32 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2004 Jan |
Date Detail:
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Created Date: 2004-01-06 Completed Date: 2004-02-12 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 246-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Paediatric Intensive Care, Royal Liverpool Children's Hospital-Alder Hey, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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