• Carlos A Santacruz, Amanda Quintairos, Claudia Righy, Ilaria A Crippa, Lucio Couto, Virginie Imbault, Mongkolpun Wasineeart, Mathieu De Ryckere, and Jean-Charles Preiser.
• 1Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium. 2Department of Critical and Intensive Care Medicine, Academic Hospital Fundación Santa Fé de Bogota, Bogota, Colombia. 3Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium.
• Crit. Care Med. 2017 Oct 1; 45 (10): 1696-1701.

ObjectivesDelayed gastric emptying occurs in critically ill patients and impairs the delivery, digestion, and absorption of enteral feeding. A pathophysiologic role of the enterohormones peptide YY and ghrelin is supported by preclinical data. To compare the circulating plasma levels of peptide YY and ghrelin in control subjects and in critically ill patients, during feeding and fasting, and to search for a correlation with gastric emptying.DesignA prospective observational trial.SettingsMixed ICU of an academic hospital.SubjectsHealthy volunteers and patients expected to stay in ICU for at least 3 days in whom enteral nutrition was indicated.InterventionsNone.Measurements And Main ResultsPlasma peptide YY and ghrelin (enzyme-linked immunosorbent assay) were measured once in 10 fasting volunteers (controls) and daily from admission until day 5 of the ICU stay in 30 critically ill patients (median [interquartile range] age 63 [57-67] yr, median [interquartile range] Acute Physiology and Chronic Health Evaluation II score 21 [14-24]). Eight patients could not be fed (fasting group). In fed patients, 13 never had a gastric residual volume higher than 250 mL (low gastric residual volume group), in contrast to the high gastric residual volume group (n = 9). The plasma levels of peptide YY did not differ between patients (6.4 [0-18.1] pg/mL) and controls (4.8 [0.3-17.7] pg/mL). Ghrelin levels were lower in patients than in control (213 [54.4-522.7] vs 1,435 [1,321.9-1,869.3] pg/mL; p < 0.05). Plasma peptide YY or ghrelin did not differ between fasting and fed patients or between the high and low gastric residual volume groups.ConclusionsIn critically ill patients, plasma concentration of ghrelin significantly differs from that of controls, irrespective of the feeding status. No correlation was found between the temporal profile of ghrelin or peptide YY plasma concentration with bedside functional assessment of gastric emptying.

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