Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2017; 23(28): 5229-5236
Published online Jul 28, 2017. doi: 10.3748/wjg.v23.i28.5229
Modified B-ultrasound method for measurement of antral section only to assess gastric function and guide enteral nutrition in critically ill patients
Ying Liu, Ya-Kun Gao, Lei Yao, Li Li
Ying Liu, Ya-Kun Gao, Lei Yao, Li Li, Department of Ultrasound, Cangzhou Central Hospital, Cangzhou 061001, Hebei Province, China
Author contributions: Liu Y, Gao YK and Yao L designed the research; Liu Y, Gao YK, Yao L and Li L performed the research; Gao YK, Yao L and Li L contributed new reagents/analytic tools; Liu Y, Gao YK, Yao L and Li L analyzed the data; Liu Y wrote the paper.
Supported by Cangzhou Science and Technology Project, No. 131302097.
Institutional review board statement: This study was reviewed and approved by Cangzhou Central Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ying Liu, MD, Attending Physician, Department of Ultrasound, Cangzhou Central Hospital, No. 201 Xinhua Road, Cangzhou 061001, Hebei Province, China. 13315703225@163.com
Telephone: +86-13315703225 Fax: +86-317-2075790
Received: May 3, 2017
Peer-review started: May 4, 2017
First decision: June 1, 2017
Revised: June 13, 2017
Accepted: June 19, 2017
Article in press: June 19, 2017
Published online: July 28, 2017
Abstract
AIM

To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people, and evaluate its application in guiding enteral nutrition (EN) in critically ill patients.

METHODS

First, 30 healthy volunteers were selected. The modified B-ultrasound method and the traditional B-ultrasound method were applied to assess gastric function. The correlation of indices of gastric function between the two groups was analyzed statistically. In addition, 64 critically ill patients were selected, and the modified B-ultrasound method and the gastric juice withdrawal method were applied to guide the implementation of EN. Daily caloric value, the time required to achieve complete EN, ICU stay, hospitalization time, and serum prealbumin and albumin levels were recorded and compared between the two groups. Kaplan-Meier survival curve was used to compare the complications of EN between the two groups.

RESULTS

In healthy subjects, there was a good correlation among gastric emptying time, antral contraction frequency and antral motility index between the two groups (r = 0.57, 0.61 and 0.54, respectively). The study on critically ill patients also revealed that a better effect of EN was achieved in the modified B-ultrasound method group, in which patients had shorter ICU stay and hospitalization time and higher levels of serum prealbumin and albumin. The Kaplan-Meier survival analysis revealed that the improved B-ultrasound method was associated with significantly fewer EN complications (P = 0.031).

CONCLUSION

The modified B-ultrasound method can provide a good real-time assessment of gastric function and has a better effect than the traditional method in guiding EN in critically ill patients.

Keywords: Gastric emptying, Real-time ultrasound, Critically ill patients, Enteral nutrition

Core tip: In order to provide critically ill patients with timely postoperative enteral nutrition (EN), a modified B-ultrasound method for measurement of antral section only was established. In healthy subjects, there was a good correlation among gastric emptying time, antral contraction frequency and antral motility index between the modified and traditional methods. The study on critically ill patients also revealed that a better effect of EN was achieved in the modified B-ultrasound method group with regard to patients’ hospitalization conditions and the incidence of EN complications.