title: Gastric emptying and intestinal transit of various enteral feedings following severe burn injury.
abstract: BACKGROUND
  Burn-induced delayed gastric emptying and intestinal transit limits enteral feeding/resuscitation.
  
  
  OBJECTIVE
  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 semi-solids, 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.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0655, USA.
authors.forename: Hanaa S
authors.initials: HS
authors.lastname: Sallam
authors.forename: George C
authors.initials: GC
authors.lastname: Kramer
authors.forename: Jiande D Z
authors.initials: JD
authors.lastname: Chen
mesh_terms: D000818:Animals; D002056:Burns / Q000503:physiopathology* / Q000628:therapy; D004750:Enteral Nutrition; D005440:Fluid Therapy; D005746:Gastric Emptying; D005772:Gastrointestinal Transit; D006400:Hematocrit; D008297:Male; D009930:Organic Chemicals / Q000627:therapeutic use; D010952:Plasma Substitutes / Q000627:therapeutic use; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D009930:Organic Chemicals; D010952:Plasma Substitutes; C011567:Vivonex