Interleukin‐10 and Zonulin Are Associated With Postoperative Delayed Gastric Emptying in Critically Ill Surgical Pediatric Patients: A Prospective Pilot Study

Delivery of enteral nutrition in critically ill patients is often hampered by gastric stasis necessitating direct feeding into the small intestine. Current techniques for placement of post-pyloric feeding catheters are complex, time consuming or both, and improvements in feeding tube placement techniques are required. The Cathlocator™ is a novel device that permits real time localisation of the end of feeding tubes via detection of a magnetic field generated by a small electric current in a coil incorporated in the tip of the tube. We performed a pilot study evaluating the feasibility of the Cathlocator™ system to guide and evaluate the placement of (1) nasoduodenal feeding tubes, and (2) nasogastric drainage tubes in critically ill patients with feed intolerance due to slow gastric emptying. A prospective study of eight critically ill patients was undertaken in the intensive care unit of a tertiary hospital. The Cathlocator™ was used to (1) guide the positioning of the tubes post-pylorically and (2) determine whether nasogastric and nasoduodenal tubes were placed correctly. Tube tip position was compared with data obtained by radiology. Data are expressed as median (range). Duodenal tube placement was successful in 7 of 8 patients (insertion time 12.6 min (5.3–34.4)). All nasogastric tube placements were successful (insertion time 3.4 min (0.6–10.0)). The Cathlocator™ accurately determined the position of both tubes without complication in all cases. The Cathlocator™ allows placement and location of an enteral feeding tube in real time in critically ill patients with slow gastric emptying. These findings warrant further studies into the application of this technique for placement of post-pyloric feeding tubes.

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Prucalopride for the treatment of delayed gastric emptying after pancreaticoduodenectomy: a pilot study

HPB ◽

10.1016/j.hpb.2018.06.2217 ◽

2018 ◽

Vol 20 ◽

pp. S632

Author(s):

D. Pagano ◽

S. Calamia ◽

C. Ricotta ◽

S. Li Petri ◽

F. di Francesco ◽

...

Keyword(s):

Gastric Emptying ◽

Pilot Study ◽

Delayed Gastric Emptying

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Amylin is associated with delayed gastric emptying in critically ill children

Intensive Care Medicine ◽

10.1007/s00134-002-1224-7 ◽

2002 ◽

Vol 28 (3) ◽

pp. 336-340 ◽

Cited By ~ 22

Author(s):

Anton-Paul T. Mayer ◽

Andrew Durward ◽

Charles Turner ◽

Sophie Skellett ◽

Neil Dalton ◽

...

Keyword(s):

Gastric Emptying ◽

Critically Ill ◽

Delayed Gastric Emptying ◽

Critically Ill Children

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590 What Is the Most Appropriate Gastric Residual Volume to Identify Delayed Gastric Emptying in Critically Ill Patients?

Gastroenterology ◽

10.1016/s0016-5085(08)60380-7 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-81

Author(s):

Nam Q. Nguyen ◽

Katrina Ching ◽

Robert J. Fraser ◽

Ross N. Butler ◽

Richard H. Holloway

Keyword(s):

Gastric Emptying ◽

Critically Ill ◽

Critically Ill Patients ◽

Delayed Gastric Emptying ◽

Residual Volume ◽

Gastric Residual Volume

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Prospective Pilot Study of Mirabegron in Pediatric Patients with Overactive Bladder

European Urology ◽

10.1016/j.eururo.2016.02.007 ◽

2016 ◽

Vol 70 (1) ◽

pp. 9-13 ◽

Cited By ~ 34

Author(s):

Anne-Sophie Blais ◽

Geneviève Nadeau ◽

Katherine Moore ◽

Lucie Genois ◽

Stéphane Bolduc

Keyword(s):

Pilot Study ◽

Overactive Bladder ◽

Pediatric Patients ◽

Prospective Pilot Study

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Incidence and Causes of Infusion Alarms in a Neonatal and Pediatric Intensive Care Unit: A Prospective Pilot Study

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-25.6.500 ◽

2020 ◽

Vol 25 (6) ◽

pp. 500-506

Author(s):

Caroline Fonzo-Christe ◽

Nathalie Bochaton ◽

Amalys Kiener ◽

Peter C. Rimensberger ◽

Pascal Bonnabry

Keyword(s):

Pilot Study ◽

Pediatric Patients ◽

Pediatric Intensive Care ◽

Occlusion Pressure ◽

Drug Injection ◽

Patient Factors ◽

Related Factors ◽

Infusion Pumps ◽

Prospective Pilot Study ◽

Event Logs

OBJECTIVES To evaluate the incidence and causes of infusion alarms in a NICU/PICU setting. METHODS We conducted a 90-day prospective analysis of event logs downloaded daily from infusion pumps (syringe and volumetric pumps). The details about conditions surrounding alarm events were described daily by bedside nurses on a standardized form. The occlusion pressure alarm was set at 300 mm Hg on each device. RESULTS Forty-one pediatric patients including 12 neonates, mean weight 11.0 ± 11.3 kg (minimum–maximum, 0.48–50), were included for a total infusion time of 2164 hours. Eight hundred forty-three infusion alarms were documented (220 [26.1%] occlusion; 273 [32.4%] infusion completed; 324 [38.4%] door open/syringe disengagement; 26 [3.1%] air-in-line) resulting in an incidence of 4.7 infusion (1.2 occlusion) alarms per patient per day. Detailed conditions surrounding occlusion alarm events were documented in only 22.7% (50/220) of the cases. Of these, 36% (18/50) were related to closed or clamped lines, 4% (2/50) to syringe change, 16% (8/50) to drug injection, and 8% (4/50) to patient-related factors. The remaining 36% (18/50) occurred without any apparent external cause during ongoing infusion, among these drug incompatibilities were a potential cause for 12 events. CONCLUSION Alarms from infusion pumps were frequent in the NICU/PICU setting, a quarter of them resulting from line occlusion. Other than well-known triggers (mechanical and patient factors), drug incompatibilities were identified as a potential cause for occlusion alarms in this pilot study.

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Apolipoprotein A-V Is a Novel Diagnostic and Prognostic Predictor in Pediatric Patients with Sepsis: A Prospective Pilot Study in PICU

Mediators of Inflammation ◽

10.1155/2020/8052954 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Chunxia Wang ◽

Yun Cui ◽

Huijie Miao ◽

Xi Xiong ◽

Jiaying Dou ◽

...

Keyword(s):

Pilot Study ◽

Pediatric Patients ◽

Characteristic Curve ◽

Kidney Injury ◽

Healthy Children ◽

Prognostic Predictor ◽

Prospective Pilot Study ◽

Serum Proteomics ◽

Apolipoprotein A

Background. Sepsis induces the release of lipid mediators, which control both lipid metabolism and inflammation. However, the role of serum apolipoprotein A-V (ApoA5) in sepsis is poorly understood in pediatric patients. Methods. ApoA5 was screened from serum proteomics profile in lipopolysaccharide- (LPS-) treated mice for 2 h, 24 h, and controls. Then, we conducted a prospective pilot study, and patients with sepsis admitted to a pediatric intensive care unit (PICU) were enrolled from January 2018 to December 2018. Serum ApoA5 levels on PICU admission were determined using enzyme-linked immunosorbent assays (ELISA). Blood samples from 30 healthy children were used as control. The correlation of ApoA5 with the clinical and laboratory parameters was analyzed. Logistic regression analyses and receiver operating characteristic curve (ROC) analysis were used to investigate the potential role of serum ApoA5 as a prognostic predictor for PICU mortality in pediatric patients with sepsis. Results. A total of 101 patients with sepsis were enrolled in this study. The PICU mortality rate was 10.9% (11/101). Serum ApoA5 levels on PICU admission were significantly lower in nonsurvivors with sepsis compared with survivors (P=0.009). In subgroup analysis, serum levels of ApoA5 were significantly correlated with sepsis-associated multiple organ dysfunction syndrome (MODS) (P<0.001), shock (P=0.002), acute kidney injury (AKI) (P<0.001), acute liver injury (ALI) (P=0.002), and gastrointestinal (GI) dysfunction (P=0.012), but not respiratory failure, brain injury, and pathogenic species (all P>0.05). Correlation analyses revealed significant correlations of serum ApoA5 with Ca2+ concentration. Remarkably, the area under ROC curve (AUC) for serum ApoA5 levels on PICU admission was 0.789 for prediction of PICU mortality with a sensitivity of 75% and a specificity of 84.5% at a threshold value of 822 ng/mL. Conclusions. Serum ApoA5 level is associated with sepsis-associated shock, AKI, ALI, GI dysfunction, or MODS in children. Moreover, the findings of the present study suggest a prognostic value of ApoA5 in children with sepsis, and lower serum ApoA5 than 822 ng/mL predicts worse outcome in pediatric sepsis.

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