Jejunal motility in children during total parenteral nutrition (TPN)

Jejunal motility in children during total parenteral nutrition (TPN)

EFFECT OF TPN ON UPPER GASTROINTESTINAL SECRETION IN RATS. E. Dardai, J.E. Heavner (Texas Tech University Health Sciences Center, Department of Anesth...

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EFFECT OF TPN ON UPPER GASTROINTESTINAL SECRETION IN RATS. E. Dardai, J.E. Heavner (Texas Tech University Health Sciences Center, Department of Anesthesiology, Lubbock, Texas, USA) The aim of this study was to investigate the influence of 10% dextrose (Dl.0W)and 5% amino acid (5%&X) solutions on gastric and duodenal secretion in experimental rat model. Eight Sprague-Dawley rats weighing between 300-400 g underwent external jugular vein and carotic artery canulation. Chronic gastric and duodenal fistulae were perEormed under halothane anesthesia. In the first seven days after surgery, the rats were fed orally. After 12 hours fast, the animals randomly received Ringer's solution, Dl0W + electrolytes and 5%AA (Aminosyn) + electrolytes intravenously in amount of 15 ml/100 g rat in three consecutive 12 hours. Blood glucose, BUN, Se. creatinin, free FA were determined. Elevated blood glucose was found in the beginning of the experiment and under Dl0W. BUN raised under 5%AA infusion. Free FA decreased under Dl0W infusion. Data gained under Ringer's infusion served as control. The gastric, duodenal fluid and urine were collected and analyzed, 5%AA 5%AA DlOW DlOW Gastric fluid Duodenal fluid Volume + 38.5% f 26.3% Volume 50% - 65% HCl f 41.5% +67 % Protein - 66% 54% Pepsin - 3 % -47 % Amylase - 59% - 48% No uniform changes in bilirubin or bicarbonate content of duodenal fluid occurred. Urinary N-excretion decreased by 42.1% under Dl0W infusion. TPN has a modifying effect on volume and content of digestive secretions. This may be beneficial in management of small intestinal fistu1ae.l The stimulating effect on gastric secretion need to be anticipated in the early period of TPN.

JEJUNAL MOTILITY IN CHILDREN DURING TOTAL PARENTERAL NUTRITION (TPN). M. Bouchoucha, 0. Goulet, M. Hero, P. Arhan, D. Pellerin, C. Ricour (C.H.U. Necker-Enfants Malades, Paris, France). Motor activity of the jejunum was recorded in order to determine if TPN could change characteristics of the "activity front" (phase 3 of the migrating motor complexes:MMC) Seven children from 1 to 14 years old in cyclic TPN (80 Kcal, 350 mgN/kg/24h), since 3 to 18 months for small bowel resection or severe mucosal atrophy were studied. They have been compared to five children from 1 to 12 years without digestive diseases, in oral alimentation, studied 12 hours after the last meal. The motor patterns of the jejunum were recorded using a multilumen polyvinyl tube passed by nose. Four recording sites, spanning 5 cm of tube and featuring a nitrogen hydraulic infusion system were used to obtain records during 3 to 6 hours. The patterns of the phase 3 were (MZSEM): Health children 123

Mean period between MMC's (min.) Rate of contractions (No/min) during phase

'_ 72.5

12.6 :

0.9

Children with TPN 60.7 t 15.1 12

Z

0.6

Duration of the phase 3 (min.)

5.2 '_ 0.6

5.7

:

0.8

Velocity of migration of MMC (cm/mn)

4.7 :

1.5

4.9

"

1.9

There is no significative difference between the two groups. These results show that cyclic parenteral nutrition does not affect the jejunal motility in children.

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