GASTRIC-EMPTYING IN MALE NEUROLOGIC TRAUMA

Prolonged gastric emptying half-time (GET1/2) has been observed in sev eral neurological disorders. Most patients with moderate to severe neu rologic trauma (NT) initially do not tolerate enteral or nasogastric f eedings. However, previous findings of altered gastric emptying (GE) i n patients with NT have been questionable. Quantitative measurements o f GE, to determine a possible mechanism for intolerance to enteral fee ding, are lacking. In this study, we measured GET1/2 sec of solid and liquid meals by radionuclide imaging in men who were neurologic trauma patients. Methods: A prospective study was conducted to assess GET1/2 in 30 men who were patients with spinal cord injuries (SCIs) and 20 m en who were patients with head injuries (HIs) using radionuclide-label ed solid and liquid meals, respectively. Meanwhile, 18 and 14 male con trol subjects underwent the same imaging techniques for solid and liqu id meals, respectively, to evaluate the normal ranges of solid and liq uid GET1/2 sec (84.5 +/- 16.7 and 29.2 +/- 3.7 min). Results: In the 3 0 SCI patients, GET1/2 of solid meals was significantly prolonged (138 .3 +/- 49.2 min, p < 0.05), and 53% (16/30) of patients had abnormal G ET1/2. A more prolonged GET1/2 and a higher incidence of abnormal GET1 /2 were observed in patients with high-level injury, when compared wit h patients with low-level injury (p ( 0.05). In the 20 HI patients, GE T1/2 of liquid meals was prolonged significantly (51.7 +/- 24.8 min, p < 0.05), and 65% (13/20) of patients had abnormal GET1/2. Coma, as in dicated by the Glasgow Coma Scale scare, was not a statistically signi ficant factor influencing GET1/2 (p >0.05). Conclusion: NT can cause s ignificantly prolonged GE, especially in patients with high-level SCI.