Gastric Emptying and Intestinal Transit of Various Enteral Feedings Following Severe Burn Injury
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Hanaa S. Sallam George C. Kramer Jiande D. Z. Chen
- چاپ و سال / کشور: 2011
Description
Background Burn-induced delayed gastric emptying and intestinal transit limits enteral feeding/resuscitation. Aims To study (1) the effects of burn injury on gastric emptying and intestinal transit at different time points following enteral feeding/fluids, and (2) the effects of enteral resuscitative fluids on gastric emptying, intestinal transit, and plasma volume expansion. Methods Rats were randomized into sham-burn and burn groups. They were either enterally untreated or treated by a gavage of one or multiple doses of oral rehydration solution (ORS) or, Vivonex, all mixed with phenol red as a marker, at different time points from 1 to 6 h after burn. Gastric emptying, intestinal transit and hematocrit values were assessed. Gastric emptying of a semi-solid methylcellulose meal served as a standard control for gastric emptying studies. Results We found that (1) burn did not alter the gastric emptying of ORS, but delayed its intestinal transit at all time points; (2) burn delayed the gastric emptying of both methylcellulose or Vivonex and the intestinal transit of Vivonex, 6 h after burn; and (3) multiple doses of ORS normalized the elevated post-burn hematocrit values. The percentage of plasma volume expansion at 6 h resulting from the multiple-dose ORS was superior to that of Vivonex by 50%. Addition of Erythromycin to Vivonex improved its gastric emptying, intestinal transit, and plasma volume expansion. Conclusions Burn delays the gastric emptying of semisolids, but not the ORS. Enteral electrolyte solution (ORS) and feeding (Vivonex) provided plasma volume expansion. Prokinetic drugs may be able to maximize the effectiveness of early post-burn feeding.
Dig Dis Sci DOI 10.1007/s10620-011-1755-2 Received: 22 February 2011 / Accepted: 11 May 2011
