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Gastric Emptying and Intestinal Transit of Various Enteral Feedings Following Severe Burn Injury

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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®, 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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Conflict of interest

The authors have no conflicts of interest.

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Authors and Affiliations

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

    Hanaa S. Sallam & Jiande D. Z. Chen

  2. Department of Anesthesiology, Resuscitation Research Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-1102, USA

    George C. Kramer

Authors
  1. Hanaa S. Sallam
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  2. George C. Kramer
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  3. Jiande D. Z. Chen
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Correspondence to Jiande D. Z. Chen.

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Sallam, H.S., Kramer, G.C. & Chen, J.D.Z. Gastric Emptying and Intestinal Transit of Various Enteral Feedings Following Severe Burn Injury. Dig Dis Sci 56, 3172–3178 (2011). https://doi.org/10.1007/s10620-011-1755-2

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  • DOI: https://doi.org/10.1007/s10620-011-1755-2

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