Noncoagulating Enteral Formula Can Empty Faster From the Stomach

Kuyumcu, Sena; Menne, Dieter; Curcic, Jelena; Goetze, Oliver; Klebach, M.; Abrahamse, Evan; Hofman, Zandrie; Fried, Michael; Schwizer, Werner; Steingoetter, Andreas

doi:10.1177/0148607114528981

Cited by 16 publications

(9 citation statements)

References 21 publications

(45 reference statements)

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“…Of them, 113 articles were eligible for full‐text screening, and 30 articles were included for detailed review. 1 , 2 , 3 , 4 , 15 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 The agreement between the authors in the inclusion process, depending on the screening phase, ranged between 94.6% (Cohen's κ = 0.73) at level 1 and 80.5% (Cohen's κ = 0.61) at level 2, showing substantial agreement in both. The inclusion process is illustrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Restrictions based on the cardiorespiratory or neurological status were enforced only by a few studies (five studies, 17%). 1 , 3 , 33 , 39 , 45 In only one study, the health status of the HVs was assessed by physical evaluation 36 ; otherwise, it was assessed by self‐reporting. Half of the studies had age or BMI restrictions (15 studies, 50%).…”

Section: Resultsmentioning

confidence: 99%

“… 47 Of the latter, eight studies (73%) did not report how the boundary of the stomach was defined in the segmentation process. 1 , 21 , 25 , 26 , 27 , 33 , 38 , 39 …”

Section: Resultsmentioning

confidence: 99%

“…The reported T50 ranged from 7 min of water (0 kcal, 240 ml) to 330 min of fat emulsion (530 kcal, 300 g). Of the included studies, one (4%) utilized the Elashoff model, 40 three (12%) utilized a PowExp model, 1 , 23 , 44 eight (32%) utilized a LinExp model, 15 , 21 , 25 , 27 , 31 , 38 , 39 , 41 five (20%) did not report the model utilized, while the rest (seven studies, 28%) utilized other models. For a comprehensive overview of the different T50 values and the other variables of the included studies, see Appendix 4 .…”

Section: Resultsmentioning

confidence: 99%

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Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review

Bertoli

Steinkohl

Mark

et al. 2022

Neurogastroenterology Motil

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Background Several magnetic resonance imaging (MRI) protocols have been used to assess gastric emptying (GE) with MRI. This systematic review summarizes the current literature on the topic. The aim was to provide an overview of the available imaging protocols and underline the items that appear most agreed upon and those that deserve further investigation. Methods According to PRISMA guidelines, two independent reviewers conducted a systematic literature search with a pre‐specified strategy in different databases. Peer‐reviewed articles that utilized MRI techniques to assess GE in healthy volunteers (HVs) were included. The quality and the outcomes of the studies were reported and analyzed. Key Results The literature search yielded 30 studies (531 HVs, weighted mean age 27.4, weighted mean body mass index 23.0 kg/m2), T2‐weighted sequences, balanced turbo field echo, and balanced gradient echo were evenly utilized, with volunteers in the supine position (74% of the studies). After overnight fasting, both liquid (56%) and mixed (44%) meals were equally utilized. Segmentation of the volumes was predominantly performed manually (63%) with a reported mean T50 ranging from 7 to 330 min. Conclusions & Inferences As observed in this systematic review, MRI is a flexible tool for assessing GE. Different protocols were analyzed, showing an equal capacity to assess the GE. However, many items in these protocols still require further investigation to obtain a common standard and increase this assessment quality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“… 47 Of the latter, eight studies (73%) did not report how the boundary of the stomach was defined in the segmentation process. 1 , 21 , 25 , 26 , 27 , 33 , 38 , 39 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review

Bertoli

Steinkohl

Mark

et al. 2022

Neurogastroenterology Motil

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“…The subject characteristics may provide a possible explanation for the favorable outcomes on gastrointestinal tolerance in this study; for example, intolerance and high gastric residual volumes are more frequently observed in head trauma patients [ 30 ]. Moreover, both formulas used in this study are based on a protein blend (P4 protein blend comprised of whey, casein, soy, and pea) that has been shown in in vitro studies and in non-critically ill patients to be noncoagulating and emptied faster by the stomach than a standard formula based on casein [ 31 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

Very high intact-protein formula successfully provides protein intake according to nutritional recommendations in overweight critically ill patients: a double-blind randomized trial

et al. 2018

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BackgroundOptimal energy and protein provision through enteral nutrition is essential for critically ill patients. However, in clinical practice, the intake achieved is often far below the recommended targets. Because no polymeric formula with sufficient protein content is available, adequate protein intake can be achieved only by supplemental amino acids or semi-elemental formula administration. In the present study, we investigated whether protein intake can be increased with a new, very high intact-protein formula (VHPF) for enteral feeding.MethodsIn this randomized, controlled, double-blind, multicenter trial, 44 overweight (body mass index ≥ 25 kg/m2) intensive care unit patients received either a VHPF (8 g/100 kcal) or a commercially available standard high protein formula (SHPF) (5 g/100 kcal). Protein and energy intake, gastrointestinal tolerance (gastric residual volume, vomiting, diarrhea, and constipation), adverse events, and serious adverse events were recorded. Total serum amino acid levels were measured at baseline and day 5.ResultsThe primary outcome, protein intake at day 5, was 1.49 g/kg body weight (95% CI 1.21–1.78) and 0.76 g/kg body weight (95% CI 0.49–1.03, P < 0.001) for VHPF and SHPF, respectively. Daily protein intake was statistically significantly higher in the VHPF group compared with the SHPF group from day 2 to day 10. Protein intake in the VHPF group as a percentage of target (1.5 g/kg ideal body weight) was 74.7% (IQR 53.2–87.6%) and 111.6% (IQR 51.7–130.7%) during days 1–3 and days 4–10, respectively. Serum amino acid concentrations were higher at day 5 in the VHPF group than in the SHPF group (P = 0.031). No differences were found in energy intake, measures of gastrointestinal tolerance, and safety.ConclusionsEnteral feeding with VHPF (8 g/100 kcal) resulted in higher protein intake and plasma amino acid concentrations than an isocaloric SHPF (5 g/100 kcal), without an increase in energy intake. This VHPF facilitates feeding according to nutritional guidelines and is suitable as a first-line nutritional treatment for critically ill overweight patients.Trial registrationNetherlands Trial Register, NTR5643. Registered on 2 February 2016.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2070-5) contains supplementary material, which is available to authorized users.

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Effects of Standard vs Energy‐Dense Formulae on Gastric Retention, Energy Delivery, and Glycemia in Critically Ill Patients

Chapple

Summers

Weinel

et al. 2021

J Parenter Enteral Nutr

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Background: Energy-dense formulae are often provided to critically ill patients with enteral feed intolerance with the aim of increasing energy delivery, yet the effect on gastric emptying is unknown. The rate of gastric emptying of a standard compared with an energy-dense formula was quantified in critically ill patients. Methods: Mechanically ventilated adults were randomized to receive radiolabeled intragastric infusions of 200 mL standard (1 kcal/mL) or 100 mL energy-dense (2 kcal/mL) enteral formulae on consecutive days in this noninferiority, blinded, crossover trial. The primary outcome was scintigraphic measurement of gastric retention (percentage at 120 minutes). Other measures included area under the curve (AUC) for gastric retention and intestinal energy delivery (calculated from gastric retention of formulae over time), blood glucose (peak and AUC), and intestinal glucose absorption (using 3-O-methyl-D-gluco-pyranose [3-OMG] concentrations). Comparisons were undertaken using paired mixedeffects models. Data presented are mean ± SE. Results: Eighteen patients were studied (male/female, 14:4; age, 55.2 ± 5.3 years). Gastric retention at 120 minutes was greater with the energy-dense formula (standard, 17.0 ± 5.9 vs energy-dense, 32.5 ± 7.1; difference, 12.7% [90% confidence interval, 0.8%-30.1%]). Energy delivery (AUC 120 , 13,038 ± 1119 vs 9763 ± 1346 kcal/120 minutes; P = 0.057), glucose control (peak glucose, 10.1 ± 0.3 vs 9.7 ± 0.3 mmol/L, P = 0.362; and glucose AUC 120 8.7 ± 0.3 vs 8.5 ± 0.3 mmol/L.120 minutes, P = 0.661), and absorption (3-OMG AUC 120 , 38.5 ± 4.0 vs 35.7 ± 4.0 mmol/L.120 minutes; P = .508) were not improved with the energy-dense formula. Conclusion: In critical illness, administration of an energy-dense formula does not reduce gastric retention, increase energy delivery to the small intestine, or improve glucose absorption or glucose control; instead, there is a signal for delayed gastric emptying.

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Noncoagulating Enteral Formula Can Empty Faster From the Stomach

Cited by 16 publications

References 21 publications

Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review

Quantification of gastric emptying with magnetic resonance imaging in healthy volunteers: A systematic review

Very high intact-protein formula successfully provides protein intake according to nutritional recommendations in overweight critically ill patients: a double-blind randomized trial

Effects of Standard vs Energy‐Dense Formulae on Gastric Retention, Energy Delivery, and Glycemia in Critically Ill Patients

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