The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness.

The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness. Research Abstract Details 

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The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness. Abstract Text:

Nam Q Nguyen,Marianne J Chapman,Robert J Fraser,Laura K Bryant,Carly Burgstad,Katrina Ching,Max Bellon,Richard H Holloway,

OBJECTIVE: To evaluate the effects of sedation with morphine and midazolam (M&M) versus propofol on gastric emptying in critically ill patients. DESIGN: Descriptive study. SETTING: Mixed medical and surgical intensive care unit. PATIENTS: Thirty-six unselected, mechanically ventilated, critically ill patients. INTERVENTIONS: Gastric scintigraphic data were analysed retrospectively according to whether patients were receiving M&M (n[Symbol: see text]=[Symbol: see text]20; 14M, 6F) or propofol (n[Symbol: see text]=[Symbol: see text]16; 7M, 9F). Measurements were performed over 4[Symbol: see text]h after administration of 100[Symbol: see text]ml of Ensure((R)), labelled with 20[Symbol: see text]MBq Tc(99m). MEASUREMENTS AND RESULTS: Gastric half-emptying time (t(1/2)) and total and regional (proximal and distal stomach) meal retention (%) were assessed. The median t(1/2) of patients receiving M&M (153 (IQR: 72-434) min) was significantly longer than that of patients receiving propofol (58 (34-166) min, p[Symbol: see text]=[Symbol: see text]0.02). Total gastric retention was greater in patients receiving M&M compared to those receiving propofol (p[Symbol: see text]<[Symbol: see text]0.01). Proximal (p[Symbol: see text]=[Symbol: see text]0.02) but not distal (p[Symbol: see text]=[Symbol: see text]0.80) gastric retention was greater in patients who received M&M. Patients who received M&M were more likely to have[Symbol: see text]>/=[Symbol: see text]5% meal retention at 240[Symbol: see text]min than thosetreated with propofol (95% (19/20) vs. 56% (9/16); p[Symbol: see text]=[Symbol: see text]0.01). Changes in blood glucose concentrations during the study were similar in the two groups. CONCLUSIONS: In critical illness, patients receiving M&M for sedation are more likely to have slow gastric emptying, and proximal meal retention than those receiving propofol. The apparent beneficial effects of propofol-based sedation need confirmation by a prospective randomised controlled study.

The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness. Publishing Authors By Initials

NQ Nguyen,MJ Chapman,RJ Fraser,LK Bryant,C Burgstad,K Ching,M Bellon,RH Holloway,

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The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Intensive care medicine

VOLUME: 34

Page Numbers: 454-60

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ISSN: 0342-4642

DAY: 4

MONTH: 12

YEAR: 2007

The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness. Information

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LANGUAGE: eng

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AFFILIATION: Departmentof Gastroenterology and Hepatology, Royal Adelaide Hospital, North Terrace, SA 5000, Adelaide, Australia, namphoung28@hotmail.com.

Country: United States

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MEDLINETA: Intensive Care Med

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