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Type: Journal article
Title: Gastric emptying and the organization of antro-duodenal pressures in the critically ill
Author: Chapman, M.
Fraser, R.
Bryant, L.
Yandell, R.
Nguyen, Q.
Tam, W.
Zacharakis, B.
Davidson, G.
Butler, R.
Horowitz, M.
Citation: Neurogastroenterology and Motility, 2008; 20(1):27-35
Publisher: Blackwell Publishing Ltd
Issue Date: 2008
ISSN: 1350-1925
Statement of
M. J. Chapman, R. J. Fraser, L. K. Bryant, R. Vozzo, N. Q. Nguyen, W. Tam, B. Zacharakis, G. Davidson,R. Butler & M. Horowitz
Abstract: 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.
Keywords: gastrointestinal motility
intensive care
propagated pressure waves
DOI: 10.1111/j.1365-2982.2007.00984.x
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