Bor Canan, Bordin Dmitry, Demirag Kubilay, Uyar Mehmet
Department of Anaesthesiology, Division of Intensive Care, Ege University School of Medicine, İzmir, Turkey.
Turk J Gastroenterol. 2016 May;27(3):216-20. doi: 10.5152/tjg.2016.16019. Epub 2016 Apr 1.
BACKGROUND/AIMS: Gastrointestinal motility problems and delayed gastric emptying in patients admitted to intensive care units are important because they can contribute to different problems. Herein we aimed to measure the changes in gastric myoelectrical activity with electrogastrography (EGG) following brain death (BD) and compare the results to those from patients in a deep coma without BD.
Fifteen patients with BD and nine in a deep coma with a Glasgow Coma Score from 3 to 8 were included. An enteral nutrition solution was given via a nasogastric tube between 45 min of fasting and the postprandial periods. The mean dominant frequency (MnDF), normal gastric slow wave ratio (%), tachygastria and bradygastria (%), power ratio (PR: dominant power after test meal/fasting), and dominant frequency instability coefficient were evaluated.
The median of MnDF was determined 3.20±0.6 (BD) vs 3.05±0.5 (control), p>0.05. Patients with BD displayed tachygastria, particularly during the fasting state, with this disturbance decreasing during the postprandial period (from 41% to 15%). However, none of the differences between the groups were statistically significant. PR was pathologic in 4/15 (26.7%) patients in the BD group and 4/9 (44.4%) patients in the control group (p=0.288).
Patients with coma or BD bouth might have gastric myoelectrical activity disturbances. BD does not show more severe disturbance than coma wihouth BD. EGG might be useful as a non-invasive and easy-to-use technology; however, it needs further improvement.
背景/目的：重症监护病房患者的胃肠动力问题和胃排空延迟很重要，因为它们会引发各种不同问题。在此，我们旨在通过胃电图（EGG）测量脑死亡（BD）后胃肌电活动的变化，并将结果与无BD的深度昏迷患者的结果进行比较。
纳入15例BD患者和9例格拉斯哥昏迷评分为3至8分的深度昏迷患者。在禁食45分钟至餐后期间，通过鼻胃管给予肠内营养溶液。评估平均主频（MnDF）、正常胃慢波比例（%）、胃动过速和胃动过缓（%）、功率比（PR：试餐后优势功率/禁食时）以及主频不稳定系数。
MnDF的中位数为3.20±0.6（BD组）对3.05±0.5（对照组），p>0.05。BD患者表现出胃动过速，尤其是在禁食状态下，这种紊乱在餐后期间有所减轻（从41%降至15%）。然而，两组之间的差异均无统计学意义。BD组4/15（26.7%）的患者和对照组4/9（44.4%）的患者PR值异常（p = 0.288）。
昏迷或BD患者可能都存在胃肌电活动紊乱。BD并不比无BD的昏迷表现出更严重的紊乱。EGG可能作为一种非侵入性且易于使用的技术有用；然而，它需要进一步改进。
