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

• Published in: Digestive diseases and sciences Vol. 56; no. 11; pp. 3172 - 3178
• Main Authors: Sallam, Hanaa S., Kramer, George C., Chen, Jiande D. Z.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.11.2011; Springer; Springer Nature B.V
• Subjects: Animals; Biochemistry; Biological and medical sciences; Burns; Burns - physiopathology; Burns - therapy; Burns and scalds; Enteral Nutrition; Feeding. Feeding behavior; Fluid Therapy; Fundamental and applied biological sciences. Psychology; Gastric Emptying; Gastroenterology; Gastrointestinal Transit; Hematocrit; Hepatology; Male; Medical sciences; Medicine; Medicine & Public Health; Methylcellulose; Oncology; Organic Chemicals - therapeutic use; Original Article; Plasma Substitutes - therapeutic use; Rats; Rats, Sprague-Dawley; Transplant Surgery; Traumas. Diseases due to physical agents; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Burn; ORS; Gastric emptying; Vivonex; Intestinal transit; Enteral resuscitation; Gastroenterology; Gut; Metabolic diseases; Resuscitation; Feeding
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-011-1755-2

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.