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Intensive Care Medicine

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01-07-2008 | Original

Diminished functional association between proximal and distal gastric motility in critically ill patients

Authors: Nam Q. Nguyen, Robert J. Fraser, Laura K. Bryant, Marianne Chapman, Richard H. Holloway

Published in: Intensive Care Medicine | Issue 7/2008

Abstract

Objective

This study examined the effects of critical illness on the relationship between proximal and distal gastric motor activity during fasting and duodenal nutrient stimulation.

Design

Prospective, case-controlled study.

Patients and participants

Ten critically ill patients and ten healthy volunteers.

Interventions

Concurrent proximal gastric (barostat) and antro-pyloro-duodenal (manometry) motility were recorded during fasting and during two 60-min duodenal nutrient infusions (Ensure at 1 kcal/min and 2 kcal/min) in random order, separated by a 2-h wash-out period.

Results

Baseline proximal gastric volumes were similar between the two groups. At 10 min nutrient-induced fundic relaxation was lower in patients than healthy subjects (45 ± 26 vs. 196 ± 29 ml). In patients the frequency and volume amplitude of fundic waves were also lower. There were fewer propagated antral waves in patients than in healthy subjects during both fasting and nutrient infusion. These were more retrograde, shorter in length and associated with a pyloric contraction. The proportion of fundic waves followed by a distally propagated antral wave was significantly less in patients (0%, 0–8%) than controls 36% (11–44%).

Conclusions

In critical illness, in addition to impairment of proximal and distal gastric motor activity, the association between the two gastric regions is abnormal. This disturbance may interfere with meal distribution and further contribute to slow gastric emptying in these patients.

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Title: Diminished functional association between proximal and distal gastric motility in critically ill patients
Authors: Nam Q. Nguyen
Robert J. Fraser
Laura K. Bryant
Marianne Chapman
Richard H. Holloway
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1036-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diminished functional association between proximal and distal gastric motility in critically ill patients

Abstract

Objective

Design

Patients and participants

Interventions

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Patients and participants

Interventions

Results

Conclusions

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