title: Total bilirubin in nasogastric aspirates: a potential new indicator of postoperative gastrointestinal recovery.
abstract: BACKGROUND
  The aim of our study was to investigate if total bilirubin (T-bil), amylase (Amy), and sodium (Na) in nasogastric (NG) aspirates can reflect gastrointestinal motility reliably.
  
  
  METHODS
  NG aspirates from all laparotomies lasting more than 150 min in children less than 12 months old were studied for 3 months. Color of aspirates and intensity of bowel sounds were graded every 3 h by nursing staff and aspirate samples for measuring T-bil, Amy, and Na were collected independently every 12 h until an oral fluid challenge was tolerated.
  
  
  RESULTS
  There were 26 subjects. Mean age at surgery was 5.6 months; mean body weight at surgery was 5.8 kg. No postoperative complications occurred. While there was no reduction in average volume of NG aspirates, color change was subjective, and bowel sounds could not be standardized, T-bil decreased over time (0d: 4.4 mg/dL; 0.5d: 2.7 mg/dL; 1.0d: 1.6 mg/dL; 1.5d: 1.3 mg/dL; 2.0d: 0.4 mg/dL; 2.5d: 0.33 mg/dL; 3.0d: 0.21 mg/dL; 3.5d: 0.15 mg/dL; 4.0d: 0.06 mg/dL; 4.5d: 0.05 mg/dL; 5.0d: 0.02 mg/dL; 5.5d: 0.02 mg/dL; 6.0d: 0.01 mg/dL). Amy and Na were inconclusive.
  
  
  CONCLUSIONS
  T-bil levels in NG aspirates may be useful as a reliable objective quantitative marker of gastrointestinal motility postoperatively.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Miyano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
mesh_terms: D001663:Bilirubin / Q000032:analysis*; D013505:Digestive System Surgical Procedures; D005751:Gastric Lavage; D005766:Gastrointestinal Contents / Q000737:chemistry*; D005767:Gastrointestinal Diseases / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007223:Infant; D011184:Postoperative Period; D020127:Recovery of Function; D013270:Stomach
chemical_list: D001663:Bilirubin