title: Is Hydrogen Breath Test with Lactulose Feasible for Measuring Gastrocecal Transit in Critically Ill Children? Pilot Study about Modification of the Technique.
abstract: Introduction. Gastrocecal transit time (GCTT) can be measured by exhaled hydrogen after lactulose intake (lactulose-eH2test). The objectives were to assess whether it is possible to carry out this test in critically ill children with and without mechanical ventilation (MV) and to analyze whether the results are consistent with clinical findings.Methods. Patients admitted to the Pediatric Intensive Care Unit (PICU) for more than 3 days were included. Those with gastrointestinal disease prior to admission were excluded. A modified technique to obtain eH2from the ventilator tubes was performed.Results. Sixteen patients (37.5% boys) with a median age of 19 (5-86.5) months were included. Five patients (31.2%) were breathing spontaneously but lactulose-eH2test could not be performed while it could be performed successfully in the 11 patients with MV. Seven patients (63.3%) did not show an eH2peak. The other 4 showed a median time of 130 min (78.7-278.7 min) from lactulose intake to a 10 ppm eH2peak. Children with an eH2peak had intestinal movements earlier [6.5 (1.5-38.5) versus 44 (24-72) hoursp= 0.545].Conclusion. Although the designed adaption is useful for collecting breath samples, lactulose-eH2test may not be useful for measuring GCTT in critically ill children.
authors.affiliation: Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine, Complutense University of Madrid, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network (Red SAMID) of Carlos III Health Institute, Spain.
authors.forename: J
authors.identifier: 0000-0002-9942-6399
authors.initials: J
authors.lastname: López
authors.affiliation: Gastroenterology Unit, Gregorio Marañón General University Hospital, Complutense University of Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Sánchez
authors.affiliation: Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine, Complutense University of Madrid, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network (Red SAMID) of Carlos III Health Institute, Spain.
authors.forename: S N
authors.identifier: 0000-0003-4859-5966
authors.initials: SN
authors.lastname: Fernández
authors.affiliation: Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine, Complutense University of Madrid, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network (Red SAMID) of Carlos III Health Institute, Spain.
authors.forename: R
authors.initials: R
authors.lastname: González
authors.affiliation: Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine, Complutense University of Madrid, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network (Red SAMID) of Carlos III Health Institute, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Solana
authors.affiliation: Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine, Complutense University of Madrid, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network (Red SAMID) of Carlos III Health Institute, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Urbano
authors.affiliation: Gastroenterology Unit, Gregorio Marañón General University Hospital, Complutense University of Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Tolín
authors.affiliation: Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, School of Medicine, Complutense University of Madrid, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network (Red SAMID) of Carlos III Health Institute, Spain.
authors.forename: J
authors.identifier: 0000-0001-6105-9178
authors.initials: J
authors.lastname: López-Herce
mesh_terms: D000293:Adolescent; D001944:Breath Tests / Q000379:methods*; D002648:Child; D016638:Critical Illness; D005240:Feasibility Studies; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D006859:Hydrogen / Q000032:analysis*; D007223:Infant; D007792:Lactulose / Q000032:analysis*; D008297:Male; D010865:Pilot Projects; D012121:Respiration, Artificial
chemical_list: D007792:Lactulose; D006859:Hydrogen