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

Hanaa Sallam, George Kramer, Jiande D Z Chen

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)3172-3178
Number of pages7
JournalDigestive Diseases and Sciences
Volume56
Issue number11
DOIs
StatePublished - Nov 2011

Fingerprint

Gastric Emptying
Enteral Nutrition
Rehydration Solutions
Fluid Therapy
Wounds and Injuries
Plasma Volume
Burns
Methylcellulose
Hematocrit
Small Intestine
Phenolsulfonphthalein
Erythromycin
Resuscitation
Electrolytes
Meals
Vivonex

Keywords

  • Burn
  • Enteral resuscitation
  • Gastric emptying
  • Intestinal transit
  • ORS
  • Vivonex

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Gastric emptying and intestinal transit of various enteral feedings following severe burn injury. / Sallam, Hanaa; Kramer, George; Chen, Jiande D Z.

In: Digestive Diseases and Sciences, Vol. 56, No. 11, 11.2011, p. 3172-3178.

Research output: Contribution to journalArticle

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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 {\circledR}, 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.",
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