Mesenteric blood flow, glucose absorption and blood pressure responses to small intestinal glucose in critically ill patients older than 65 years

Sim, Jennifer A.; Horowitz, Michael; Summers, Matthew J.; Trahair, Laurence G.; Goud, Rajendra; Zaknic, Antony V.; Hausken, Trygve; Fraser, Jonathan David; Chapman, Marianne J.; Deane, Adam M.

doi:10.1007/s00134-012-2719-5

Cited by 35 publications

(36 citation statements)

References 32 publications

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“…Our data support previous observations that not only is glucose absorption lower in the critically ill, but subsequent metabolism is disordered (4,20). Consistent with previous studies, increased glucagon with inadequate insulin secretion appeared important determinants of disordered glucose metabolism in this group (16,17).…”

Section: Discussionsupporting

confidence: 92%

“…The primary observation is that critical illness is associated with markedly reduced intestinal levels of SGLT-1, GLUT2 and STR (T1R2) transcripts in both humans and a mouse model, providing a plausible explanation for the carbohydrate malabsorption observed during critical illness (4,10,20,25).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the load and rate of glucose administered into the small intestine were controlled by direct intraduodenal infusion; this is important because the rate of nutrient delivery from the stomach into the small intestine is a major determinant of glucose absorption, glycaemia and the secretion of GLP-1 and GIP (36), and gastric emptying is known frequently to be delayed in the critically ill (20,37).…”

Section: Discussionmentioning

confidence: 99%

“…If insulin was being administered, infusions were ceased at least 2 hours before the study. Healthy subjects ingested a liquid nutrient meal the night before the study to replicate recent exposure to enteral feeding in the critically ill (20).…”

Section: Protocolmentioning

confidence: 99%

See 3 more Smart Citations

The Effects of Critical Illness on Intestinal Glucose Sensing, Transporters, and Absorption*

Deane

Rayner

Keeshan³

et al. 2014

Critical Care Medicine

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Protocolmentioning

confidence: 99%

See 2 more Smart Citations

The Effects of Critical Illness on Intestinal Glucose Sensing, Transporters, and Absorption*

Deane

Rayner

Keeshan³

et al. 2014

Critical Care Medicine

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“…Sim et al [78] assessed the superior mesenteric artery (SMA) blood flow and glucose absorption in critically ill elderly patients. Using Doppler ultrasonography before and after a glucose meal, the authors found that in SMA flow was stimulated less by nutrients in elderly patients compared to healthy elderly volunteers and glucose absorption was reduced in the critically ill patients.…”

Section: Nutrition and Intestinal Failurementioning

confidence: 99%

Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition

et al. 2013

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Blinded, Double‐Dummy, Parallel‐Group, Phase 2a Randomized Clinical Trial to Evaluate the Efficacy and Safety of a Highly Selective 5‐Hydroxytryptamine Type 4 Receptor Agonist in Critically Ill Patients With Enteral Feeding Intolerance

Chapman

Jones

Almansa

et al. 2020

J Parenter Enteral Nutr

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Background Delayed gastric emptying is the leading cause of enteral feeding intolerance (EFI) in critical illness. This phase 2a study compared TAK‐954, a selective agonist of 5‐hydroxytryptamine type 4 receptors, with metoclopramide in critically ill patients with EFI (NCT01953081). Methods A blinded, double‐dummy trial was conducted in mechanically ventilated patients with EFI (>200 mL gastric residual volume within 24 hours before randomization). Patients were randomized to receive either 0.5 mg intravenous TAK‐954 over 1 hour then 0.9% saline injection 4 times/d (sham metoclopramide) or the active comparator 10 mg intravenous metoclopramide 4 times/d and a 1‐hour 0.9% saline infusion. After initial dosing, participants received a radiolabeled meal of liquid nutrient (Ensure; 106 kcal), and gastric emptying was measured (scintigraphy). Adverse events (AEs) were recorded from the time of consent through to day 5; serious AEs were collected to day 30. Results Thirteen patients (TAK‐954, n = 7; metoclopramide, n = 6) participated. Five patients in the TAK‐954 group and 4 in the metoclopramide group experienced AEs (2 and 3, respectively, were serious). All AEs except 1 (diarrhea in the metoclopramide group) were considered unrelated to study drug. Following treatment, a greater proportion of patients receiving TAK‐954 had normal gastric retention (<13% retention at 180 minutes) than those receiving metoclopramide (6/7 vs 3/6 patients, respectively). Conclusion A single dose of 0.5 mg intravenous TAK‐954 appears to have at least similar efficacy in accelerating gastric emptying to multiple doses of 10 mg metoclopramide and was not associated with increased AEs.

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Mesenteric blood flow, glucose absorption and blood pressure responses to small intestinal glucose in critically ill patients older than 65 years

Cited by 35 publications

References 32 publications

The Effects of Critical Illness on Intestinal Glucose Sensing, Transporters, and Absorption*

The Effects of Critical Illness on Intestinal Glucose Sensing, Transporters, and Absorption*

Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition

Blinded, Double‐Dummy, Parallel‐Group, Phase 2a Randomized Clinical Trial to Evaluate the Efficacy and Safety of a Highly Selective 5‐Hydroxytryptamine Type 4 Receptor Agonist in Critically Ill Patients With Enteral Feeding Intolerance

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