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https://hdl.handle.net/2440/52276
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Type: | Journal article |
Title: | The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness |
Author: | Nguyen, Q. Chapman, M. Fraser, R. Bryant, L. Burgstad, C. Ching, K. Bellon, M. Holloway, R. |
Citation: | Intensive Care Medicine, 2008; 34(3):454-460 |
Publisher: | Springer |
Issue Date: | 2008 |
ISSN: | 0342-4642 1432-1238 |
Statement of Responsibility: | Nam Q. Nguyen, Marianne J. Chapman, Robert J. Fraser, Laura K. Bryant, Carly Burgstad, Katrina Ching, Max Bellon and Richard H. Holloway |
Abstract: | <h4>Objective</h4>To evaluate the effects of sedation with morphine and midazolam (M&M) versus propofol on gastric emptying in critically ill patients.<h4>Design</h4>Descriptive study.<h4>Setting</h4>Mixed medical and surgical intensive care unit.<h4>Patients</h4>Thirty-six unselected, mechanically ventilated, critically ill patients.<h4>Interventions</h4>Gastric scintigraphic data were analysed retrospectively according to whether patients were receiving M&M (n=20; 14M, 6F) or propofol (n=16; 7M, 9F). Measurements were performed over 4 h after administration of 100 ml of Ensure, labelled with 20 MBq Tc99m.<h4>Measurements and results</h4>Gastric half-emptying time (t1/2) and total and regional (proximal and distal stomach) meal retention (%) were assessed. The median t1/2 of patients receiving M&M (153 (IQR: 72-434) min) was significantly longer than that of patients receiving propofol (58 (34-166) min, p=0.02). Total gastric retention was greater in patients receiving M&M compared to those receiving propofol (p<0.01). Proximal (p=0.02) but not distal (p=0.80) gastric retention was greater in patients who received M&M. Patients who received M&M were more likely to have >or=5% meal retention at 240 min than those treated with propofol (95% (19/20) vs. 56% (9/16); p=0.01). Changes in blood glucose concentrations during the study were similar in the two groups.<h4>Conclusions</h4>In critical illness, patients receiving M&M for sedation are more likely to have slow gastric emptying, and proximal meal retention than those receiving propofol. The apparent beneficial effects of propofol-based sedation need confirmation by a prospective randomised controlled study. |
Keywords: | Gastrointestinal Tract Stomach Humans Critical Illness Technetium Propofol Morphine Midazolam Dietary Sucrose Hypnotics and Sedatives Narcotics Radionuclide Imaging Gastrointestinal Transit Body Mass Index Respiration, Artificial Enteral Nutrition Retrospective Studies Gastric Emptying Food, Formulated Middle Aged Intensive Care Units Female Male |
Description: | The original publication can be found at www.springerlink.com |
DOI: | 10.1007/s00134-007-0942-2 |
Published version: | http://dx.doi.org/10.1007/s00134-007-0942-2 |
Appears in Collections: | Aurora harvest Medicine publications |
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