Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients
(1) Background: Acute muscle inflammation leads to increased sonographic echodensity. We developed a technique to characterize the echodensity of the gastric antrum wall and assess its feasibility in evaluating the severity of acute gastrointestinal injury (AGI); (2) Methods: The B-mode images of th...
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MDPI AG
2022-01-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/3/566 |
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| author | Luping Wang Hao Yang Guangxuan Lv Xin Fu Yisong Cheng Xi Zhong Jing Yang Bo Wang Zhongwei Zhang Xiaodong Jin Yan Kang Qin Wu |
| author_facet | Luping Wang Hao Yang Guangxuan Lv Xin Fu Yisong Cheng Xi Zhong Jing Yang Bo Wang Zhongwei Zhang Xiaodong Jin Yan Kang Qin Wu |
| author_sort | Luping Wang |
| collection | DOAJ |
| description | (1) Background: Acute muscle inflammation leads to increased sonographic echodensity. We developed a technique to characterize the echodensity of the gastric antrum wall and assess its feasibility in evaluating the severity of acute gastrointestinal injury (AGI); (2) Methods: The B-mode images of the gastric antrum of each enrolled patient were obtained daily by point-of-care ultrasound (POCUS). The 50th percentile, 85th percentile, and mean value of the grayscale distribution according to histogram analysis (ED<sub>50</sub>, ED<sub>85</sub>, and ED<sub>mean</sub>, respectively) were used to characterize the gastric antrum echodensity. Consistency and correlation analyses were performed to evaluate the feasibility and reproducibility of gastric antrum echodensity measurement. The association of gastric antrum echodensity with the severity of AGI and its ability to predict feeding intolerance (FI) were analyzed; (3) Results: In total, 206 POCUS images of 43 patients were analyzed. The gastric antrum echodensity measurements had sufficient intra- and inter-investigator reliabilities (intraclass correlation coefficient >0.9 for all parameters). The ED<sub>50</sub> showed a significant upward trend as AGI severity increased, as well as ED<sub>85</sub> and ED<sub>mean</sub> (<i>p</i> for trend <0.001, respectively). Patients who experienced FI had a higher ED<sub>50</sub> (67.8 vs. 56.1, <i>p</i> = 0.02), ED<sub>85</sub> (85.6 vs. 71.2, <i>p</i> = 0.01), and ED<sub>mean</sub> (70.3 vs. 57.6, <i>p</i> = 0.01) upon enteral feeding initiation; (4) Conclusions: Measurement of gastric antrum echodensity was technically feasible and reproducible in ventilated patients. Increased gastric antrum echodensity was associated with greater severity of AGI. Patients with higher gastric antrum echodensity upon enteral nutrition initiation via a nasogastric tube were more likely to develop FI. |
| first_indexed | 2024-03-09T23:21:45Z |
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| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T23:21:45Z |
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| spelling | doaj.art-cf18e9c50ef44d6898e17cf124522bdf2023-11-23T17:25:54ZengMDPI AGNutrients2072-66432022-01-0114356610.3390/nu14030566Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill PatientsLuping Wang0Hao Yang1Guangxuan Lv2Xin Fu3Yisong Cheng4Xi Zhong5Jing Yang6Bo Wang7Zhongwei Zhang8Xiaodong Jin9Yan Kang10Qin Wu11Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, ChinaDepartment of Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Road, Chengdu 610041, China(1) Background: Acute muscle inflammation leads to increased sonographic echodensity. We developed a technique to characterize the echodensity of the gastric antrum wall and assess its feasibility in evaluating the severity of acute gastrointestinal injury (AGI); (2) Methods: The B-mode images of the gastric antrum of each enrolled patient were obtained daily by point-of-care ultrasound (POCUS). The 50th percentile, 85th percentile, and mean value of the grayscale distribution according to histogram analysis (ED<sub>50</sub>, ED<sub>85</sub>, and ED<sub>mean</sub>, respectively) were used to characterize the gastric antrum echodensity. Consistency and correlation analyses were performed to evaluate the feasibility and reproducibility of gastric antrum echodensity measurement. The association of gastric antrum echodensity with the severity of AGI and its ability to predict feeding intolerance (FI) were analyzed; (3) Results: In total, 206 POCUS images of 43 patients were analyzed. The gastric antrum echodensity measurements had sufficient intra- and inter-investigator reliabilities (intraclass correlation coefficient >0.9 for all parameters). The ED<sub>50</sub> showed a significant upward trend as AGI severity increased, as well as ED<sub>85</sub> and ED<sub>mean</sub> (<i>p</i> for trend <0.001, respectively). Patients who experienced FI had a higher ED<sub>50</sub> (67.8 vs. 56.1, <i>p</i> = 0.02), ED<sub>85</sub> (85.6 vs. 71.2, <i>p</i> = 0.01), and ED<sub>mean</sub> (70.3 vs. 57.6, <i>p</i> = 0.01) upon enteral feeding initiation; (4) Conclusions: Measurement of gastric antrum echodensity was technically feasible and reproducible in ventilated patients. Increased gastric antrum echodensity was associated with greater severity of AGI. Patients with higher gastric antrum echodensity upon enteral nutrition initiation via a nasogastric tube were more likely to develop FI.https://www.mdpi.com/2072-6643/14/3/566gastric antrum echodensityacute gastrointestinal injurypoint-of-care ultrasoundfeeding intolerance |
| spellingShingle | Luping Wang Hao Yang Guangxuan Lv Xin Fu Yisong Cheng Xi Zhong Jing Yang Bo Wang Zhongwei Zhang Xiaodong Jin Yan Kang Qin Wu Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients Nutrients gastric antrum echodensity acute gastrointestinal injury point-of-care ultrasound feeding intolerance |
| title | Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients |
| title_full | Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients |
| title_fullStr | Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients |
| title_full_unstemmed | Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients |
| title_short | Association of Gastric Antrum Echodensity and Acute Gastrointestinal Injury in Critically Ill Patients |
| title_sort | association of gastric antrum echodensity and acute gastrointestinal injury in critically ill patients |
| topic | gastric antrum echodensity acute gastrointestinal injury point-of-care ultrasound feeding intolerance |
| url | https://www.mdpi.com/2072-6643/14/3/566 |
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