Nutrient-stimulated gallbladder emptying is incomplete during critical illness as assessed by 3D ultrasound

Methods Twenty-four critically ill patients (16M:8F, age 54 ± 16y, BMI 29 ± 6kg/m, APACHE II 17 ± 5, SOFA score 7.5 ± 4, day of admission 5 ± 4) with no history of biliary pathology were compared to 12 healthy volunteers (8M:4F, age 55 ± 19, BMI 24 ± 4). All participants were fasted for 8 hours and had a feeding catheter inserted into the duodenum. At T = -30min 3D images of the gallbladder were acquired and wall thickness and presence of sludge recorded. Between T = 0-120min 20% intralipid was infused into the duodenum at 2kcal/min. Ultrasound measurements of the gallbladder were obtained at 30min intervals until T = 180min. Ejection fraction (%) and the change in gallbladder volume (mls) were calculated from T = 0-120min. Blood samples were taken at 30 minute intervals for the measurement of plasma CCK. Differences between groups were analysed using Student’s t-test or Mann-Whitney test as appropriate and data are presented as mean (SD) or median [IQR]. Unadjusted correlation analyses were performed for demographic, ultrasound and CCK data.