胃排空
胰淀素
医学
激素
内科学
肠内给药
生长素
肽YY
胃肠病学
肠外营养
内分泌学
胃动素
胰高血糖素
胆囊收缩素
肽类激素
胰岛素
胃
神经肽
小岛
受体
神经肽Y受体
作者
Enid E. Martinez,Courtney Panciotti,Luis M. Pereira,Mark D. Kellogg,Nicholas Stylopoulos,Nilesh M. Mehta
摘要
Abstract Background Enteral nutrition (EN) intolerance and delayed gastric emptying are prevalent in pediatric critical illness and limit EN delivery. Gastrointestinal (GI) hormones may be associated with EN intolerance and delayed gastric emptying in this cohort. Methods We determined GI hormone levels, time to achieve 50% of EN goal, and gastric emptying in critically ill children. Total amylin, active ghrelin, total glucagon‐like peptide‐1 (GLP‐1), total gastric inhibitory polypeptide, glucagon, and total peptide‐YY (PYY) were measured by multiplex assay and cholecystokinin by ELISA. Lower concentrations of acetaminophen at 1 hour (C1h, µg/mL) using the acetaminophen absorption test defined delayed gastric emptying. Correlation, regression analyses, and a principal component analysis were used to examine the association between GI hormones and time to 50% EN goal and C1h. Results GI hormones were measured in 14 of 21 patients with gastric emptying testing; median age of 11.2 years (6.74–16.3) and 50% male. Increasing hormone levels from GI hormone profile 1 (GLP‐1, glucagon, and amylin) correlated with greater time to reach 50% EN goal ( R 2 = 0.296, P = 0.04). Decreasing hormone levels from GI hormone profile 2 (PYY and ghrelin) correlated with lower C1h and slower gastric emptying ( R 2 = 0.342, P = 0.02). Conclusion GI hormone profiles are associated with time to achieve 50% of EN goal and gastric emptying in critically ill children. We have described a feasible model to study the role of GI hormones in this cohort, including the potential clinical applicability of GI hormone measurement in the management of delayed gastric emptying.
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