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Glucose absorption and small intestinal transit in critical illness*
MedLine Citation:
PMID:  21336122     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION:: Although enteral nutrition is standard care for critically ill patients, nutrient absorption has not been quantified in this group and may be impaired due to intestinal dysmotility. The objectives of this study were to measure small intestinal glucose absorption and duodenocecal transit and determine their relationship with glycemia in the critically ill. MATERIALS AND METHODS:: Twenty-eight critically ill patients and 16 healthy subjects were studied in a prospective observational study. Liquid feed (100 kcal/100 mL), labeled with Tc-sulfur colloid and including 3 g of 3-O-methylglucose, was infused into the duodenum. Glucose absorption and duodenocecal transit were measured using the area under the 3-O-methylglucose concentration curve and scintigraphy, respectively. Data are median (range). RESULTS AND DISCUSSION:: Glucose absorption was reduced in critical illness when compared to health (area under the concentration curve: 16 [1-32] vs. 20 [14-34] mmol/L·min; p = .03). Small intestinal transit times were comparable in patients and healthy subjects (192 [9-240] vs. 168 [6-240] min; p = .99) and was not related to glucose absorption. Despite higher fasting blood glucose concentrations (6.3 [5.1-9.3] vs. 5.7 [4.6-7.6] mmol/L; p < .05), the increment in blood glucose was sustained for longer in the critically ill (Δ glucose at t = 60; 1.9 [-2.1-5.0] mmol/L vs. -0.2 [-1.3-2.3] mmol/L; p < .01). CONCLUSIONS:: Critical illness is associated with reduced small intestinal glucose absorption, but despite this, the glycemic response to enteral nutrient is sustained for longer.
Authors:
A M Deane; M J Summers; A V Zaknic; M J Chapman; A E Di Bartolomeo; M Bellon; A Maddox; A Russo; M Horowitz; R J L Fraser
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-17
Journal Detail:
Title:  Critical care medicine     Volume:  -     ISSN:  1530-0293     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the National Health and Medical Research Council of Australia Centre for Clinical Research Excellence in Nutritional Physiology and Outcomes (AMD, MJC, RJLF), Adelaide, South Australia; Intensive Care Unit (AD, MJS, AVJ, MJC), Level 4, Royal Adelaide Hospital, Adelaide, South Australia; Discipline of Acute Care Medicine (AD, MJC, AEDB), University of Adelaide, Adelaide, South Australia; Department of Nuclear Medicine (MB, AM, AR), Royal Adelaide Hospital, Adelaide, South Australia; Discipline of Medicine (MH, RJLF), University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia; and Investigation and Procedures Unit (RJLF), Repatriation General Hospital, Daw Park, South Australia, Australia.
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