The effects of sedation on gastric emptying and intra-gastric meal distribution in critical illness
| Autor: | Laura K. Bryant, Nam Q. Nguyen, Richard H. Holloway, Katrina Ching, Robert J. Fraser, Marianne J. Chapman, Carly M. Burgstad, Max Bellon |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Narcotics genetic structures medicine.drug_class Critical Illness Midazolam Sedation Critical Care and Intensive Care Medicine Body Mass Index Hypnotic Enteral Nutrition Dietary Sucrose Intensive care Humans Hypnotics and Sedatives Medicine heterocyclic compounds Gastrointestinal Transit Radionuclide Imaging Propofol Retrospective Studies Food Formulated Morphine Gastric emptying business.industry Stomach Technetium Middle Aged Respiration Artificial Gastrointestinal Tract Intensive Care Units medicine.anatomical_structure Gastric Emptying Anesthesia Sedative Female medicine.symptom business medicine.drug |
| Zdroj: | Intensive Care Medicine. 34:454-460 |
| ISSN: | 1432-1238 0342-4642 |
| DOI: | 10.1007/s00134-007-0942-2 |
| Popis: | To evaluate the effects of sedation with morphine and midazolam (MM) versus propofol on gastric emptying in critically ill patients.Descriptive study.Mixed medical and surgical intensive care unit.Thirty-six unselected, mechanically ventilated, critically ill patients.Gastric scintigraphic data were analysed retrospectively according to whether patients were receiving MM (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.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 MM (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 MM compared to those receiving propofol (p0.01). Proximal (p=0.02) but not distal (p=0.80) gastric retention was greater in patients who received MM. Patients who received MM were more likely to haveor=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.In critical illness, patients receiving MM 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. |
| Databáze: | OpenAIRE |
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