Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 7, 2010; 16(17): 2151-2157
Published online May 7, 2010. doi: 10.3748/wjg.v16.i17.2151
Impact of bolus volume on small intestinal intra-luminal impedance in healthy subjects
Nam Q Nguyen, Laura K Bryant, Carly M Burgstad, Robert J Fraser, Daniel Sifrim, Richard H Holloway
Nam Q Nguyen, Carly M Burgstad, Richard H Holloway, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, Adelaide 5000, Australia
Laura K Bryant, Robert J Fraser, Investigation and Procedures Unit, Repatriation General Hospital, Daw Park 5041, Australia
Daniel Sifrim, Department of Medicine, Centre for Gastroenterological Research, K.U. Leuven, Leuven 3000, Belgium
Author contributions: Nguyen NQ was responsible for study design, data interpretation, statistical analysis and drafting of the manuscript; Holloway RH and Fraser RJ contributed equally to study conception and design, data interpretation and manuscript completion; Bryant LK and Burgstad CM were involved in data acquisition, analysis and manuscript revision; Sifrim D was involved in methodological design and interpretation of data; all authors read and approved the final manuscript.
Supported by The National Health and Medical Research Council of Australia
Correspondence to: Dr. Nam Q Nguyen, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, North Terrace, Adelaide 5000, Australia. quoc.nguyen@health.sa.gov.au
Telephone: +61-8-82224000 Fax: +61-8-82225885
Received: May 8, 2009
Revised: August 13, 2009
Accepted: August 20, 2009
Published online: May 7, 2010
Abstract

AIM: To assess the impact of bolus volume on the characteristics of small intestinal (SI) impedance signals.

METHODS: Concurrent SI manometry-impedance measurements were performed on 12 healthy volunteers to assess the pattern of proximal jejunal fluid bolus movement over a 14 cm-segment. Each subject was given 34 boluses of normal saline (volume from 1 to 30 mL) via the feeding tube placed immediately above the proximal margin of the studied segment. A bolus-induced impedance event occurred if there was > 12% impedance drop from baseline, over ≥ 3 consecutive segments within 10 s of bolus injection. A minor or major impedance event was defined as a duration of impedance drop < 60 s or ≥ 60 s, respectively.

RESULTS: The minimum volume required for a detectable SI impedance event was 2 mL. A direct linear relationship between the SI bolus volume and the occurrence of impedance events was noted until SI bolus volume reached 10 mL, a volume which always produced an impedance flow event. There was a moderate correlation between the bolus volume and the duration of impedance drop (r = 0.63, P < 0.0001) and the number of propagated channels (r = 0.50, P < 0.0001). High volume boluses were associated with more major impedance events (≥ 10 mL boluses = 63%, 3 mL boluses = 17%, and < 3 mL boluses = 0%, P = 0.02).

CONCLUSION: Bolus volume had an impact on the type and length of propagation of SI impedance events and a threshold of 2 mL is required to produce an event.

Keywords: Bolus volume; Health; Impedance; Luminal flow; Small intestine