Abstract
Gastric mucosal ischemia may be a risk factor for gastrointestinal intolerance to early feeding in the critically ill. To study intragastric PCO2 air tonometry and gastric residual volumes (GRV) before and after the start of gastric feeding. This is a two-center study in intensive care units of a university and teaching hospital. Twenty-nine critically ill, consecutive and consenting patients scheduled to start gastric feeding were studied after insertion of a gastric tonometry catheter and prior to and after start of gastric feeding (500ml over 1h), when clinically indicated. Blood gasometry and intragastric tonometry were performed prior to and 2h after gastric feeding. The intragastric to arterial PCO2 gap (normal <8mm Hg) was elevated in 41% of patients prior to feeding and measured (mean±standard deviation) 13±20 and 16±23mm Hg in patients with normal (<100ml, 42±34ml, n=19) and elevated GRV (250±141ml, n=10, P=0.75), respectively. After feeding, the gradient did not increase and measured 27±25 and 23±34mm Hg, respectively (P=0.80). Gastric mucosal ischemia is not a major risk factor for intolerance to early gastric feeding in the critically ill.
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