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Impact of enteral feeding on gastric tonometry in healthy volunteers and critically ill patients
Author(s) -
Rokyta Jr R.,
Novák I.,
Matějovič M.,
Hora P.,
Nalos M.,
Šrámek V.
Publication year - 2001
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2001.045005564.x
Subject(s) - medicine , bolus (digestion) , enteral administration , stomach , pco2 , gastroenterology , parenteral nutrition , anesthesia
Background: Enteral feeding may interfere with gastric tonometry measurement. The effect of enteral nutrition on gastric tonometry has not been fully documented. Methods: Seven healthy volunteers and nine stable intensive care unit (ICU) patients with poor tolerance of gastric feeding were investigated. Consecutive continuous postpyloric and gastric feeding, both at two different rates (40 and 100 ml · h −1 , respectively), and an intragastric 200 ml nutrition bolus were studied. Gastric intramucosal PCO 2 (PiCO 2 ) was measured by air tonometry and in patients a gastric intramucosal‐arterial PCO 2 difference (PCO 2 gap) was calculated. Hemodynamics and blood gases were also measured. Results: In volunteers, PiCO 2 remained stable during the postpyloric phase. During continuous gastric feeding PiCO 2 did not change significantly, although in 4 volunteers PiCO 2 increased >0.5 kPa. PiCO 2 decreased significantly after gastric bolus from 6.9±0.4 to 6.1±0.5 kPa ( P <0.05). Eight patients had an increased PCO 2 gap (>1 kPa) at baseline (1.8±0.6 kPa). PCO 2 gap changes during the whole study were not statistically significant. However, during the postpyloric phase (or immediately afterwards), the PCO 2 gap increased by more than 0.5 kPa in 5 patients. After gastric bolus, a decrease in PCO 2 gap >0.5 kPa was seen in 5 patients. Conclusion: In volunteers, postpyloric feeding does not interfere with gastric tonometry measurement and gastric bolus leads to a PiCO 2 decrease. The impact of postpyloric and gastric feeding on gastric tonometry in ICU patients with compromised gut is variable.