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Dig Dis Sci. 2011 Nov;56(11):3172-8. doi: 10.1007/s10620-011-1755-2. Epub 2011 May 31.

Gastric emptying and intestinal transit of various enteral feedings following severe burn injury.

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  • 1Department of Internal Medicine, Division of Gastroenterology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0655, USA.

Abstract

BACKGROUND:

Burn-induced delayed gastric emptying and intestinal transit limits enteral feeding/resuscitation.

AIMS:

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.

PMID:
21625963
[PubMed - indexed for MEDLINE]
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