Palash Kar1, Karen L Jones2, Michael Horowitz2, Marianne J Chapman3, Adam M Deane3. 1. Discipline of Acute Care Medicine, University of Adelaide, South Australia, Australia; Intensive Care Unit, Royal Adelaide Hospital, South Australia, Australia. Electronic address: p_kar@hotmail.com. 2. Centre for Research Excellence, University of Adelaide, South Australia, Australia; Discipline of Medicine, University of Adelaide, South Australia, Australia. 3. Discipline of Acute Care Medicine, University of Adelaide, South Australia, Australia; Intensive Care Unit, Royal Adelaide Hospital, South Australia, Australia; Centre for Research Excellence, University of Adelaide, South Australia, Australia.
Abstract
BACKGROUND & AIMS: Enteral nutrition is important in critically ill patients and is usually administered via a nasogastric tube. As gastric emptying is frequently delayed, and this compromises the delivery of nutrient, it is important that the emptying rate can be quantified. METHODS: A comprehensive search of MEDLINE/PubMed, of English articles, from inception to 1 July 2014. References of included manuscripts were also examined for additional studies. RESULTS: A number of methods are available to measure gastric emptying and these broadly can be categorised as direct- or indirect-test and surrogate assessments. Direct tests necessitate visualisation of the stomach contents during emptying and are unaffected by liver or kidney metabolism. The most frequently used direct modality is scintigraphy, which remains the 'gold standard'. Indirect tests use a marker that is absorbed in the proximal small intestine, so that measurements of the marker, or its metabolite measured in plasma or breath, correlates with gastric emptying. These tests include drug and carbohydrate absorption and isotope breath tests. Gastric residual volumes (GRVs) are used frequently to quantify gastric emptying during nasogastric feeding, but these measurements may be inaccurate and should be regarded as a surrogate measurement. While the inherent limitations of GRVs make them less suitable for research purposes they are often the only technique that is available for clinicians at the bedside. CONCLUSIONS: Each of the available techniques has its strength and limitations. Accordingly, the choice of gastric emptying test is dictated by the particular requirement(s) and expertise of the investigator or clinician. Crown
BACKGROUND & AIMS: Enteral nutrition is important in critically illpatients and is usually administered via a nasogastric tube. As gastric emptying is frequently delayed, and this compromises the delivery of nutrient, it is important that the emptying rate can be quantified. METHODS: A comprehensive search of MEDLINE/PubMed, of English articles, from inception to 1 July 2014. References of included manuscripts were also examined for additional studies. RESULTS: A number of methods are available to measure gastric emptying and these broadly can be categorised as direct- or indirect-test and surrogate assessments. Direct tests necessitate visualisation of the stomach contents during emptying and are unaffected by liver or kidney metabolism. The most frequently used direct modality is scintigraphy, which remains the 'gold standard'. Indirect tests use a marker that is absorbed in the proximal small intestine, so that measurements of the marker, or its metabolite measured in plasma or breath, correlates with gastric emptying. These tests include drug and carbohydrate absorption and isotope breath tests. Gastric residual volumes (GRVs) are used frequently to quantify gastric emptying during nasogastric feeding, but these measurements may be inaccurate and should be regarded as a surrogate measurement. While the inherent limitations of GRVs make them less suitable for research purposes they are often the only technique that is available for clinicians at the bedside. CONCLUSIONS: Each of the available techniques has its strength and limitations. Accordingly, the choice of gastric emptying test is dictated by the particular requirement(s) and expertise of the investigator or clinician. Crown
Authors: Palash Kar; Karen L Jones; Mark P Plummer; Yasmine Ali Abdelhamid; Emma J Giersch; Matthew J Summers; Seva Hatzinikolas; Simon Heller; Michael Horowitz; Adam M Deane Journal: J Clin Endocrinol Metab Date: 2017-11-01 Impact factor: 5.958
Authors: Marianne J Chapman; Adam M Deane; Stephanie L O'Connor; Nam Q Nguyen; Robert J L Fraser; Duncan B Richards; Kimberley E Hacquoil; Lakshmi S Vasist Johnson; Matthew E Barton; George E Dukes Journal: Crit Care Date: 2016-08-01 Impact factor: 9.097
Authors: Thu An Nguyen; Yasmine Ali Abdelhamid; Liza K Phillips; Leeanne S Chapple; Michael Horowitz; Karen L Jones; Adam M Deane Journal: World J Crit Care Med Date: 2017-02-04
Authors: Christian Schoergenhofer; Eva-Luise Hobl; Michael Schwameis; Georg Gelbenegger; Thomas Staudinger; Gottfried Heinz; Walter S Speidl; Christian Zauner; Birgit Reiter; Irene Lang; Bernd Jilma Journal: Eur J Clin Invest Date: 2017-06-20 Impact factor: 4.686
Authors: Yasmine Ali Abdelhamid; Palash Kar; Mark E Finnis; Liza K Phillips; Mark P Plummer; Jonathan E Shaw; Michael Horowitz; Adam M Deane Journal: Crit Care Date: 2016-09-27 Impact factor: 9.097
Authors: Varsha M Asrani; Harry D Yoon; Robin D Megill; John A Windsor; Maxim S Petrov Journal: Medicine (Baltimore) Date: 2016-02 Impact factor: 1.889