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Prevalence and Measurement of Delayed Gastric Emptying in Patients Receiving Extracorporeal Membrane Oxygenation

Not Yet RecruitingN/A

Sponsor: Guy's and St Thomas' NHS Foundation Trust

Conditions: Gastric Emptying, Delayed Gastric Emptying, Critical Illness, ExtraCorporeal Membrane Oxygenation (ECMO)

Interventions: Gastric (stomach) ultrasound measurement, 'Residual volume' measurement, Scintigraphy (standard research method)

Countries: United Kingdom

* The goal of this observational study is to learn whether the stomach takes longer to empty in patients on the intensive care unit who are receiving ECMO (a machine that temporarily takes over the role of the lungs and heart) compared to patients receiving support through a breathing machine (mechanical ventilation) only. It will also find the best way to measure stomach emptying at the bedside. * The main questions it aims to answer are: * What is the prevalence of slow stomach emptying and other stomach or bowel problems in patients receiving ECMO, compared to patients receiving mechanical ventilation but not receiving ECMO? (Stage A) * What is the best bedside method to measure stomach emptying in patients receiving ECMO? (Stage B) * Stage A of the study will involve measuring stomach emptying in study participants within four days of ICU admission, using two bedside methods: * 'Residual volumes' (removing liquid nutrition left in the stomach with a syringe, after this has been given through the participant's usual feeding tube) * A stomach ultrasound scan The researchers will check for differences between patients receiving ECMO versus no ECMO, and how this relates to the nutrition patients receive and how well or unwell they become in ICU. * In a smaller subgroup of patients receiving ECMO and participating in Stage B of the study, the researchers will also use scintigraphy. This is a standard research scan that tracks how the stomach empties by mixing a small, safe amount of radioactivity in the participant's usual liquid nutrition. The researchers will compare stomach emptying results from 'residual volumes' and stomach ultrasound with scintigraphy.

Eligibility overview

Sex: ALL

Age: 18 Years to 80 Years

Healthy volunteers: No

Study type: OBSERVATIONAL

Eligibility criteria

* INCLUSION CRITERIA (non-ECMO group):

  * Within 72 hours of Guy's \& St Thomas' ICU admission
  * Mechanically ventilated adults (≥18 years)
  * Receiving enteral nutrition (liquid nutrition) via a gastric (nasogastric or orogastric) feeding tube
  * Informed consent / advice for participation by consultee
  * Availability of study investigator or other trained healthcare professional on site to complete gastric emptying (stomach emptying) measurements
* INCLUSION CRITERIA (ECMO group):

  * Within 72 hours of Guy's \& St Thomas' ICU admission
  * Mechanically ventilated adults (≥18 years)
  * Receiving enteral nutrition (liquid nutrition) via a gastric (nasogastric or orogastric) feeding tube
  * Informed consent / advice for participation by consultee
  * Availability of study investigator or other trained healthcare professional on site to complete gastric emptying (stomach emptying) measurements
  * Receiving either veno-venous or veno-arterial ECMO
* EXCLUSION CRITERIA:

  * Pregnancy
  * History of gastroparesis (long-term slow stomach emptying)
  * Current acute or long-term gastrointestinal pathology (stomach or bowel problem) that may influence gastric emptying (e.g. inflammatory bowel disease, coeliac disease, pancreatic exocrine insufficiency)
  * Current contraindication to enteral nutrition (liquid nutrition) (e.g. clinical or radiological evidence of bowel obstruction, bowel ischaemia, ileus, upper gastrointestinal bleeding)
  * Enteral nutrition (liquid nutrition) through a gastrostomy, jejunostomy or nasojejunal feeding tube
  * Current or previous oesophageal, stomach or major small bowel surgery
  * Known anatomical abnormality of the stomach (e.g. hiatus hernia)
  * Pericardial / abdominal drains or surgical wounds obstructing site of ultrasound scanning
  * Nuclear medicine therapeutic administration, or diagnostic scintigraphy investigation in the previous 72 hours
  * Unlikely to survive or withdrawal of life-sustaining treatment expected in the next 48 hours

Locations (1)

London, United Kingdom