title: Gastric emptying of a liquid nutrient meal in the critically ill: relationship between scintigraphic and carbon breath test measurement.
abstract: OBJECTIVE
  It is assumed that delayed gastric emptying (GE) occurs frequently in critical illness; however, the prevalence of slow GE has not previously been assessed using scintigraphy. Furthermore, breath tests could potentially provide a convenient method of quantifying GE, but have not been validated in this setting. The aims of this study were to (i) determine the prevalence of delayed GE in unselected, critically ill patients and (ii) evaluate the relationships between GE as measured by scintigraphy and carbon breath test.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Mixed medical/surgical intensive care unit.
  
  
  METHODS
  25 unselected, mechanically ventilated patients (age 66 years (49-72); and 14 healthy subjects (age 62 years (19-84)).
  
  
  METHODS
  GE was measured using scintigraphy and (14)C-breath test. A test meal of 100 ml Ensure (standard liquid feed) labelled with (14)C octanoic acid and (99m)Technetium sulphur colloid was placed in the stomach via a nasogastric tube.
  
  
  METHODS
  Gastric 'meal' retention (scintigraphy) at 60, 120, 180 and 240 min, breath test t(50) (BTt(50)), and GE coefficient were determined.
  
  
  RESULTS
  Of the 24 patients with scintigraphic data, GE was delayed at 120 min in 12 (50%). Breath tests correlated well with scintigraphy in both patients and healthy subjects (% retention at 120 min vs BTt(50); r(2)=0.57 healthy; r(2)=0.56 patients; p≤0.002 for both).
  
  
  CONCLUSIONS
  GE of liquid nutrient is delayed in approximately 50% of critically ill patients. Breath tests correlate well with scintigraphy and are a valid method of GE measurement in this group.
authors: Department of Intensive Care Medicine, Royal Adelaide Hospital, South Australia, Australia. marianne.chapman@health.sa.gov.au
authors: M J
authors: MJ
authors: Chapman
authors: L K
authors: LK
authors: Besanko
authors: C M
authors: CM
authors: Burgstad
authors: R J
authors: RJ
authors: Fraser
authors: M
authors: M
authors: Bellon
authors: S
authors: S
authors: O'Connor
authors: A
authors: A
authors: Russo
authors: K L
authors: KL
authors: Jones
authors: K
authors: K
authors: Lange
authors: N Q
authors: NQ
authors: Nguyen
authors: F
authors: F
authors: Bartholomeusz
authors: B
authors: B
authors: Chatterton
authors: M
authors: M
authors: Horowitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis*; D002250:Carbon Radioisotopes; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods*; D045853:Exhalation; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013270:Stomach / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013671:Technetium Tc 99m Sulfur Colloid; D055815:Young Adult
chemical_list: D002250:Carbon Radioisotopes; D002245:Carbon Dioxide; D013671:Technetium Tc 99m Sulfur Colloid