Altered gastric emptying in the head-injured patient: Relationship to feeding intolerance

L. Ott, B. Young, R. Phillips, C. McClain, L. Adams, R. Dempsey, P. Tibbs, U. Yun Ryo

Research output: Contribution to journalArticlepeer-review

155 Scopus citations

Abstract

Most patients with moderate to severe head injury initially do not tolerate enteral feedings postinjury. This intolerance is more prolonged than that found in patients suffering other types of trauma. The authors prospectively evaluated 12 patients with moderate to severe head injury (Glasgow Coma Scale score between 4 and 10) throughout their hospitalization for liquid gastric emptying as a possible mechanism for intolerance to enteral feeding. During Week 1, the majority of patients displayed a delay in gastric emptying. Patients also displayed an abnormal biphasic response (gastric emptying faster than normal during the early stage but prolonged later). By Week 2, many patients still had delayed and abnormal biphasic responses to gastric emptying. By Week 3, an improvement was observed with the majority of patients exhibiting rapid gastric emptying, but delays and abnormal biphasic responses were still seen. Patients who initially had rapid or normal gastric emptying tolerated full-strength full-rate feedings significantly earlier compared with those who experienced delayed gastric emptying (8.5 ± 0.5 days vs. 13.7 ± 3.2 days, p < 0.001). All patients tolerated full-strength full-rate feedings by Day 16 postinjury (range 7 to 16 days) except the two patients who displayed delayed gastric emptying for prolonged periods of time (mean 25 days). This is the first study to longitudinally evaluate gastric emptying following head injury. The authors suggest that patients with moderate to severe head injury often experience alterations in gastric emptying which may affect their ability to tolerate enteral feedings.

Original languageEnglish
Pages (from-to)738-742
Number of pages5
JournalJournal of Neurosurgery
Volume74
Issue number5
DOIs
StatePublished - 1991

Keywords

  • corticotropin-releasing factor
  • cytokines
  • enteral feeding
  • gastric emptying
  • head injury
  • nutrition
  • opioids

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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