Evaluation of gastric emptying rate in neurosurgical patients and its correlation with intracranial pressure.

BACKGROUND AND AIMS: Real-time ultrasonography has shown good correlation in evaluating gastric emptying in previous studies. The present study aimed to examine gastric content and volume using ultrasound in neurosurgical patients admitted in the intensive care unit (ICU) and compare it with non-neurosurgical patients and assess correlation between gastric emptying and intracranial pressure.

METHODS

Forty adult patients of either gender admitted in the ICU on mechanical ventilation and receiving enteral nutrition via nasogastric tubes were included in the study and allocated into two groups: Group I (n = 20): Neurosurgical patients; Group II (n = 20): Non-neurosurgical patients with chest pathology. All patients were given 300 ml of water through a ryle's tube and ultrasound-guided gastric volume was assessed at baseline (before feed, T0) and 15 minutes (T1), 1 hour (T2), 2 hours (T3), and 4 hours (T4) after the feed. Gastric volume and gastric emptying rate (GER) were calculated using appropriate formulas. Ocular ultrasound was performed to record optic nerve sheath diameter (ONSD) in all patients.

RESULTS

There was no significant difference between the two groups in baseline values of gastric volume as well as at T1 and T2, while there was a significant difference between the two groups at T3 and T4. The mean value of GER in group I was 33.80 ± 13.29%, and that in group II was 58.24 ± 9.80% (P < 0.001). There was significant negative correlation between ONSD and GER (Pearson's correlation coefficient: -0.6; P value < 0.001).

CONCLUSION

Mechanically ventilated patients in the ICU who had neurosurgical pathology exhibited delayed gastric emptying as compared to non-neurosurgical patients.