Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/77422
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dc.contributor.authorSim, J.en
dc.contributor.authorHorowitz, M.en
dc.contributor.authorSummers, M.en
dc.contributor.authorTrahair, L.en
dc.contributor.authorGoud, R.en
dc.contributor.authorZaknic, A.en
dc.contributor.authorHausken, T.en
dc.contributor.authorFraser, J.en
dc.contributor.authorChapman, M.en
dc.contributor.authorJones, K.en
dc.contributor.authorDeane, A.en
dc.date.issued2013en
dc.identifier.citationIntensive Care Medicine, 2013; 39(2):258-266en
dc.identifier.issn0342-4642en
dc.identifier.issn1432-1238en
dc.identifier.urihttp://hdl.handle.net/2440/77422-
dc.description.abstractTo compare nutrient-stimulated changes in superior mesenteric artery (SMA) blood flow, glucose absorption and glycaemia in individuals older than 65 years with, and without, critical illness.Following a 1-h 'observation' period (t (0)-t (60)), 0.9 % saline and glucose (1 kcal/ml) were infused directly into the small intestine at 2 ml/min between t (60)-t (120), and t (120)-t (180), respectively. SMA blood flow was measured using Doppler ultrasonography at t (60) (fasting), t (90) and t (150) and is presented as raw values and nutrient-stimulated increment from baseline (Δ). Glucose absorption was evaluated using serum 3-O-methylglucose (3-OMG) concentrations during, and for 1 h after, the glucose infusion (i.e. t (120)-t (180) and t (120)-t (240)). Mean arterial pressure was recorded between t (60)-t (240). Data are presented as median (25th, 75th percentile).Eleven mechanically ventilated critically ill patients [age 75 (69, 79) years] and nine healthy volunteers [70 (68, 77) years] were studied. The magnitude of the nutrient-stimulated increase in SMA flow was markedly less in the critically ill when compared with healthy subjects [Δt (150): patients 115 (-138, 367) versus health 836 (618, 1,054) ml/min; P = 0.001]. In patients, glucose absorption was reduced during, and for 1 h after, the glucose infusion when compared with health [AUC(120-180): 4.571 (2.591, 6.551) versus 11.307 (8.447, 14.167) mmol/l min; P < 0.001 and AUC(120-240): 26.5 (17.7, 35.3) versus 40.6 (31.7, 49.4) mmol/l min; P = 0.031]. A close relationship between the nutrient-stimulated increment in SMA flow and glucose absorption was evident (3-OMG AUC(120-180) and ∆SMA flow at t (150): r (2) = 0.29; P < 0.05).In critically ill patients aged >65 years, stimulation of SMA flow by small intestinal glucose infusion may be attenuated, which could account for the reduction in glucose absorption.en
dc.description.statementofresponsibilityJennifer A. Sim, M. Horowitz, M. J. Summers, L. G. Trahair, R. S. Goud, A. V. Zaknic, T. Hausken, J. D. Fraser, M. J. Chapman, K. L. Jones, A. M. Deaneen
dc.language.isoenen
dc.publisherSpringeren
dc.rights© Springer-Verlag Berlin Heidelberg and ESICM 2012en
dc.subjectCritical illness; Superior mesenteric artery; Glucose absorption; Nutrition; Postprandial hypotension; Splanchnic blood flowen
dc.titleMesenteric blood flow, glucose absorption and blood pressure responses to small intestinal glucose in critically ill patients older than 65 yearsen
dc.typeJournal articleen
dc.identifier.rmid0020125626en
dc.identifier.doi10.1007/s00134-012-2719-5en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1025648en
dc.identifier.pubid21191-
pubs.library.collectionAnaesthesia and Intensive Care publicationsen
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
dc.identifier.orcidHorowitz, M. [0000-0002-0942-0306]en
dc.identifier.orcidChapman, M. [0000-0003-0710-3283]en
dc.identifier.orcidJones, K. [0000-0002-1155-5816]en
dc.identifier.orcidDeane, A. [0000-0002-7620-5577]en
Appears in Collections:Anaesthesia and Intensive Care publications

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