Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test
To measure gastric emptying in ventilated critically ill patients with a new noninvasive breath test. Single-center, open study. Combined medical and surgical intensive care unit of a university hospital. Thirty unselected mechanically ventilated critically ill patients receiving gastric feeding and...
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| Veröffentlicht in: | Critical care medicine 2001-09, Vol.29 (9), p.1744-1749 |
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| creator | Ritz, M A Fraser, R Edwards, N Di Matteo, A C Chapman, M Butler, R Cmielewski, P Tournadre, J P Davidson, G Dent, J |
| description | To measure gastric emptying in ventilated critically ill patients with a new noninvasive breath test.
Single-center, open study.
Combined medical and surgical intensive care unit of a university hospital.
Thirty unselected mechanically ventilated critically ill patients receiving gastric feeding and 22 healthy volunteers.
None.
After 4 hrs without feeding, intragastric infusion of 100 mL of a liquid meal (Ensure) labeled with 100 microL 13C-octanoic acid. End-expiratory breath samples were collected into evacuated tubes from the respirator circuit every 5 mins for the first hour, then every 15 mins for 3 hrs. End-expiratory breath samples were also collected from volunteers studied supine after an overnight fast following an identical infusion via a nasogastric tube. Breath 13CO2 was measured with an isotope ratio mass spectrometer.
Performance of the breath test posed no difficulty or interference with patient care. The CO2 level was >1% in 1297/1300 breath samples, indicating satisfactory end-expiratory timing. Data are median and interquartile range. Gastric emptying was slower in patients compared with volunteers: gastric emptying coefficient 2.93 (2.17-3.39) vs. 3.58 (3.18-3.79), p |
| format | Article |
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Single-center, open study.
Combined medical and surgical intensive care unit of a university hospital.
Thirty unselected mechanically ventilated critically ill patients receiving gastric feeding and 22 healthy volunteers.
None.
After 4 hrs without feeding, intragastric infusion of 100 mL of a liquid meal (Ensure) labeled with 100 microL 13C-octanoic acid. End-expiratory breath samples were collected into evacuated tubes from the respirator circuit every 5 mins for the first hour, then every 15 mins for 3 hrs. End-expiratory breath samples were also collected from volunteers studied supine after an overnight fast following an identical infusion via a nasogastric tube. Breath 13CO2 was measured with an isotope ratio mass spectrometer.
Performance of the breath test posed no difficulty or interference with patient care. The CO2 level was >1% in 1297/1300 breath samples, indicating satisfactory end-expiratory timing. Data are median and interquartile range. Gastric emptying was slower in patients compared with volunteers: gastric emptying coefficient 2.93 (2.17-3.39) vs. 3.58 (3.18-3.79), p <.001 and gastric half emptying time, derived from the area under the 13CO2 curve, 155 min (130-220) vs. 133 min (120-145), p <.008. Fourteen of the 30 patients had a gastric emptying coefficient <95% of all volunteers and 11 had a gastric half emptying time longer than 95% of all volunteers. The Acute Physiology and Chronic Health Evaluation (APACHE II) score (median 22, range 13-43) either at admission or on the day of the study did not correlate with gastric emptying coefficient.
Gastric emptying of a calorie-dense liquid meal is slow in 40% to 45% of unselected mechanically ventilated patients in a combined medical and surgical intensive care unit. The 13C-octanoic acid breath test is a novel and useful bedside technique to measure gastric emptying in these patients.</description><identifier>ISSN: 0090-3493</identifier><identifier>PMID: 11546976</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Aged, 80 and over ; APACHE ; Breath Tests - methods ; Caprylates - metabolism ; Carbon Dioxide - chemistry ; Case-Control Studies ; Critical Care ; Enteral Nutrition ; Female ; Gastric Emptying ; Humans ; Male ; Middle Aged ; Respiration, Artificial</subject><ispartof>Critical care medicine, 2001-09, Vol.29 (9), p.1744-1749</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11546976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ritz, M A</creatorcontrib><creatorcontrib>Fraser, R</creatorcontrib><creatorcontrib>Edwards, N</creatorcontrib><creatorcontrib>Di Matteo, A C</creatorcontrib><creatorcontrib>Chapman, M</creatorcontrib><creatorcontrib>Butler, R</creatorcontrib><creatorcontrib>Cmielewski, P</creatorcontrib><creatorcontrib>Tournadre, J P</creatorcontrib><creatorcontrib>Davidson, G</creatorcontrib><creatorcontrib>Dent, J</creatorcontrib><title>Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test</title><title>Critical care medicine</title><addtitle>Crit Care Med</addtitle><description>To measure gastric emptying in ventilated critically ill patients with a new noninvasive breath test.
Single-center, open study.
Combined medical and surgical intensive care unit of a university hospital.
Thirty unselected mechanically ventilated critically ill patients receiving gastric feeding and 22 healthy volunteers.
None.
After 4 hrs without feeding, intragastric infusion of 100 mL of a liquid meal (Ensure) labeled with 100 microL 13C-octanoic acid. End-expiratory breath samples were collected into evacuated tubes from the respirator circuit every 5 mins for the first hour, then every 15 mins for 3 hrs. End-expiratory breath samples were also collected from volunteers studied supine after an overnight fast following an identical infusion via a nasogastric tube. Breath 13CO2 was measured with an isotope ratio mass spectrometer.
Performance of the breath test posed no difficulty or interference with patient care. The CO2 level was >1% in 1297/1300 breath samples, indicating satisfactory end-expiratory timing. Data are median and interquartile range. Gastric emptying was slower in patients compared with volunteers: gastric emptying coefficient 2.93 (2.17-3.39) vs. 3.58 (3.18-3.79), p <.001 and gastric half emptying time, derived from the area under the 13CO2 curve, 155 min (130-220) vs. 133 min (120-145), p <.008. Fourteen of the 30 patients had a gastric emptying coefficient <95% of all volunteers and 11 had a gastric half emptying time longer than 95% of all volunteers. The Acute Physiology and Chronic Health Evaluation (APACHE II) score (median 22, range 13-43) either at admission or on the day of the study did not correlate with gastric emptying coefficient.
Gastric emptying of a calorie-dense liquid meal is slow in 40% to 45% of unselected mechanically ventilated patients in a combined medical and surgical intensive care unit. The 13C-octanoic acid breath test is a novel and useful bedside technique to measure gastric emptying in these patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>APACHE</subject><subject>Breath Tests - methods</subject><subject>Caprylates - metabolism</subject><subject>Carbon Dioxide - chemistry</subject><subject>Case-Control Studies</subject><subject>Critical Care</subject><subject>Enteral Nutrition</subject><subject>Female</subject><subject>Gastric Emptying</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Respiration, Artificial</subject><issn>0090-3493</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kE9LxDAQxXtQ3HX1K0hO3goJSZvEm6x_YcHL3ss0ma6RpK1JKvTbG1FPw_B-vDdvzqotpZrWXGi-qS5T-qCUiUbyi2rDWCNaLdttFR7Qw4qWnCDl6AzBMOfVjSfiRvKFY3YecpFNdNkZ8H4lznsyQ3ZFTHckIKQlYigb6VfCONnXk8kwTsUMjLOkjwj5nWRM-ao6H8AnvP6bu-r49Hjcv9SHt-fX_f2hnstdtaFWC6AKVKvR6kaIRvGh7TWXzKJixlDFC8FbMEa2ctAD4qA4Z5Zq2Vu-q25_bec4fS4ltwsuGfQeRpyW1Mmf_o1QBbz5A5c-oO3m6ALEtfv_D_8Gk8JhvA</recordid><startdate>200109</startdate><enddate>200109</enddate><creator>Ritz, M A</creator><creator>Fraser, R</creator><creator>Edwards, N</creator><creator>Di Matteo, A C</creator><creator>Chapman, M</creator><creator>Butler, R</creator><creator>Cmielewski, P</creator><creator>Tournadre, J P</creator><creator>Davidson, G</creator><creator>Dent, J</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200109</creationdate><title>Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test</title><author>Ritz, M A ; Fraser, R ; Edwards, N ; Di Matteo, A C ; Chapman, M ; Butler, R ; Cmielewski, P ; Tournadre, J P ; Davidson, G ; Dent, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p546-c0d94a08a869ed9544583f6b9371de81cc08394a36acc767f9feef8331d097bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>APACHE</topic><topic>Breath Tests - methods</topic><topic>Caprylates - metabolism</topic><topic>Carbon Dioxide - chemistry</topic><topic>Case-Control Studies</topic><topic>Critical Care</topic><topic>Enteral Nutrition</topic><topic>Female</topic><topic>Gastric Emptying</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Respiration, Artificial</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ritz, M A</creatorcontrib><creatorcontrib>Fraser, R</creatorcontrib><creatorcontrib>Edwards, N</creatorcontrib><creatorcontrib>Di Matteo, A C</creatorcontrib><creatorcontrib>Chapman, M</creatorcontrib><creatorcontrib>Butler, R</creatorcontrib><creatorcontrib>Cmielewski, P</creatorcontrib><creatorcontrib>Tournadre, J P</creatorcontrib><creatorcontrib>Davidson, G</creatorcontrib><creatorcontrib>Dent, J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ritz, M A</au><au>Fraser, R</au><au>Edwards, N</au><au>Di Matteo, A C</au><au>Chapman, M</au><au>Butler, R</au><au>Cmielewski, P</au><au>Tournadre, J P</au><au>Davidson, G</au><au>Dent, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test</atitle><jtitle>Critical care medicine</jtitle><addtitle>Crit Care Med</addtitle><date>2001-09</date><risdate>2001</risdate><volume>29</volume><issue>9</issue><spage>1744</spage><epage>1749</epage><pages>1744-1749</pages><issn>0090-3493</issn><abstract>To measure gastric emptying in ventilated critically ill patients with a new noninvasive breath test.
Single-center, open study.
Combined medical and surgical intensive care unit of a university hospital.
Thirty unselected mechanically ventilated critically ill patients receiving gastric feeding and 22 healthy volunteers.
None.
After 4 hrs without feeding, intragastric infusion of 100 mL of a liquid meal (Ensure) labeled with 100 microL 13C-octanoic acid. End-expiratory breath samples were collected into evacuated tubes from the respirator circuit every 5 mins for the first hour, then every 15 mins for 3 hrs. End-expiratory breath samples were also collected from volunteers studied supine after an overnight fast following an identical infusion via a nasogastric tube. Breath 13CO2 was measured with an isotope ratio mass spectrometer.
Performance of the breath test posed no difficulty or interference with patient care. The CO2 level was >1% in 1297/1300 breath samples, indicating satisfactory end-expiratory timing. Data are median and interquartile range. Gastric emptying was slower in patients compared with volunteers: gastric emptying coefficient 2.93 (2.17-3.39) vs. 3.58 (3.18-3.79), p <.001 and gastric half emptying time, derived from the area under the 13CO2 curve, 155 min (130-220) vs. 133 min (120-145), p <.008. Fourteen of the 30 patients had a gastric emptying coefficient <95% of all volunteers and 11 had a gastric half emptying time longer than 95% of all volunteers. The Acute Physiology and Chronic Health Evaluation (APACHE II) score (median 22, range 13-43) either at admission or on the day of the study did not correlate with gastric emptying coefficient.
Gastric emptying of a calorie-dense liquid meal is slow in 40% to 45% of unselected mechanically ventilated patients in a combined medical and surgical intensive care unit. The 13C-octanoic acid breath test is a novel and useful bedside technique to measure gastric emptying in these patients.</abstract><cop>United States</cop><pmid>11546976</pmid><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over APACHE Breath Tests - methods Caprylates - metabolism Carbon Dioxide - chemistry Case-Control Studies Critical Care Enteral Nutrition Female Gastric Emptying Humans Male Middle Aged Respiration, Artificial |
| title | Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test |
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