EFFECT OF ENTERAL FEEDING ON REGIONAL CO2 LEVELS IN NORMAL VOLUNTEERS

肠内喂养对正常志愿者局部二氧化碳水平的影响

• 批准号: 6309232
• 负责人: CINDA H CLARK
• 金额: $ 1.11万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2001-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6309232
• 关键词: antiulcer drug; carbon dioxide; clinical research; drug administration rate /duration; drug screening /evaluation; glaucoma test; human subject; nitrogen; nutrition related tag; oral administration; pharmacokinetics; thiazoles; tube feeding

The hypothesis of this project is that liquid enteral feeding supplements significantly affect the measurement of gastric intramucosal carbon dioxide levels (PgCO2) in normal healthy volunteers. The specific aim is to evaluate whether enteral feeding can be given into the stomach lumen via a gastric tonometer without significantly affecting the measurement of gastric regional CO2 levels. This is a pilot study to examine the effect of gastric enteral feeding on tonometrically measured PgCO2 in healthy volunteers. An air tonometry system will be utilized to monitor PgCO2 levels by a tonometer placed in the lumen of the stomach via nasogastric intubation. PgCO2 levels will be automatically monitored and recorded every 15 minutes throughout the study. Osmolite High Nitrogen (HN) will be utilized for enteral feeding. It has been well documented that the gastric tonometer is a useful tool in measurement of PgCO2 levels. Studies have demonstrated significant increases in PgCO2 with induction of endotoxemia and occlusion of the mesenteric vasculature, thus establishing the use of PgCO2 as an accurate indicator of splanchnic perfusion. PgCO2 has also been shown to be a useful guide to hemodynamic management of the critically ill. In vitro studies have demonstrated that PgCO2 can be utilized as a therapeutic index of tissue oxygenation, as a prognostic value for severity of illness, and as an index for the use of dobutamine in septic patients. However, the effect of enteral nutrition on the accuracy of tonometrically measured PgCO2 has not been studied systematically. The need to answer this question regarding the effect of enteral feeding on tonometered PgCO2 levels lies in the importance of accurately assessing the critically ill patient's hemodynamic stability related to splanchnic perfusion and ability to tolerate enteral feeding. After the effect of enteral feeding on the PgOC2 levels is established in normal volunteers, future studies will be conducted on critically ill patients. Once the effect of enteral feeding on tonometered PgCO2 is established for normal and critically ill subjects, the last study will attempt to utilize the measurement of PgCO2 to intiate early enteral feeding in the critically ill patient.

该项目的假设是，液体肠内喂养补充剂显著影响正常健康志愿者胃粘膜内二氧化碳水平(PgCO2)的测量。具体目的是评估是否可以在不显著影响胃局部二氧化碳水平测量的情况下，通过胃张力计向胃腔内给予肠内喂养。这是一项初步研究，旨在研究胃肠内喂养对健康志愿者眼压测量的PgCO2的影响。通过鼻胃插管将眼压计放置在胃腔内，利用空气眼压测量系统监测PgCO2水平。在整个研究过程中，PgCO2水平将每15分钟自动监测和记录一次。将利用渗透石高氮(HN)进行肠道喂养。已有文献表明，胃张力计是测量PgCO2水平的有用工具。研究表明，随着内毒素血症和肠系膜血管闭塞，PgCO2显著增加，从而确立将PgCO2作为内脏灌流的准确指标。PgCO2也被证明是危重病人血流动力学管理的有用指南。体外研究表明，PgCO2可以作为组织氧合的治疗指标，作为病情严重程度的预后价值，以及作为脓毒症患者使用多巴酚丁胺的指标。然而，肠内营养对眼压测量PgCO2准确性的影响还没有系统的研究。回答有关肠内喂养对眼压PgCO2水平影响的这个问题的必要性在于，准确评估与内脏灌流和耐受性肠道喂养相关的危重患者的血流动力学稳定性的重要性。在确定了肠内喂养对正常志愿者PgOC2水平的影响后，将对危重患者进行进一步的研究。一旦确定了肠内喂养对正常和危重患者眼压PgCO2的影响，最后一项研究将尝试利用PgCO2的测量来启动危重患者的早期肠内喂养。