Document Detail


Gastric emptying and the organization of antro-duodenal pressures in the critically ill.
MedLine Citation:
PMID:  18069967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The motor dysfunctions underlying delayed gastric emptying (GE) in critical illness are poorly defined. Our aim was to characterize the relationship between antro-duodenal (AD) motility and GE in critically ill patients. AD pressures were recorded in 15 mechanically ventilated patients and 10 healthy volunteers for 2 h (i) during fasting, (ii) following an intragastric nutrient bolus with concurrent assessment of GE using the (13)C-octanoate breath test and (iii) during duodenal nutrient infusion. Propagated waves were characterized by length and direction of migration. Critical illness was associated with: (i) slower GE (GEC: 3.47 +/- 0.1 vs 2.99 +/- 0.2; P = 0.046), (ii) fewer antegrade (duodenal: 44%vs 83%, AD: 16%vs 83%; P < 0.001) and more retrograde (duodenal: 46%vs 12%, AD: 38%vs 4%; P < 0.001) waves, (iii) shorter wave propagation (duodenal: 4.7 +/- 0.3 vs 6.0 +/- 0.4 cm; AD: 7.7 +/- 0.6 vs 10.9 +/- 0.9 cm; P = 0.004) and (iv) a close correlation between GE with the percentage of propagated phase 3 waves that were antegrade (r = 0.914, P = 0.03) and retrograde (r = -0.95, P = 0.014). In critical illness, the organization of AD pressure waves is abnormal and associated with slow GE.
Authors:
M J Chapman; R J Fraser; L K Bryant; R Vozzo; N Q Nguyen; W Tam; B Zacharakis; G Davidson; R Butler; M Horowitz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-12-07
Journal Detail:
Title:  Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society     Volume:  20     ISSN:  1350-1925     ISO Abbreviation:  Neurogastroenterol. Motil.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-04     Completed Date:  2008-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9432572     Medline TA:  Neurogastroenterol Motil     Country:  England    
Other Details:
Languages:  eng     Pagination:  27-35     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, Royal Adelaide Hospital, Adelaide, SA, Australia. marianne.chapman@health.sa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Critical Illness*
Duodenum / physiopathology*
Gastric Emptying*
Humans
Manometry
Peristalsis
Pressure
Pyloric Antrum / physiopathology*
Reference Values
Respiration, Artificial

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


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