Effect of ICU interventions on gastrointestinal motility

PurposeAcute gastrointestinal (GI) dysfunction and failure have been increasingly recognized in critically ill patients. The variety of definitions proposed in the past has led to confusion and difficulty in comparing one study to another. An international working group convened to standardize the definitions for acute GI failure and GI symptoms and to review the therapeutic options.MethodsThe Working Group on Abdominal Problems (WGAP) of the European Society of Intensive Care Medicine (ESICM) developed the definitions for GI dysfunction in intensive care patients on the basis of the available evidence and current understanding of the pathophysiology.ResultsDefinitions for acute gastrointestinal injury (AGI) with its four grades of severity, as well as for feeding intolerance syndrome and GI symptoms (e.g. vomiting, diarrhoea, paralysis, high gastric residual volumes) are proposed. AGI is a malfunctioning of the GI tract in intensive care patients due to their acute illness. AGI grade I = increased risk of developing GI dysfunction or failure (a self-limiting condition); AGI grade II = GI dysfunction (a condition that requires interventions); AGI grade III = GI failure (GI function cannot be restored with interventions); AGI grade IV = dramatically manifesting GI failure (a condition that is immediately life-threatening). Current evidence and expert opinions regarding treatment of acute GI dysfunction are provided.ConclusionsState-of-the-art definitions for GI dysfunction with gradation as well as management recommendations are proposed on the basis of current medical evidence and expert opinion. The WGAP recommends using these definitions for clinical and research purposes.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-011-2459-y) contains supplementary material, which is available to authorized users.

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“…Perfusion, secretion, motility and a coordinated gut–microbiome interaction are prerequisites for an adequate function [16]. …”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems

et al. 2012

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“…Loss of lean body mass is modulated by the inflammatory process and many treatment-related factors that affect muscle catabolism such as sedation and bed-rest [3]. Enteral nutrition is often insufficient to provide full caloric support and may be affected by the detrimental effect of opioids, inotropes, vasopressors, a-2 agonists and electrolyte imbalances on gastrointestinal motility [4].…”

Section: Introductionmentioning

confidence: 99%

Nutrition risk assessment in the ICU

Hiesmayr¹

2012

Current Opinion in Clinical Nutrition and Metabolic Care

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“…73,74 Patients intolerant of gastric feedings generate less acylated ghrelin contributing to gastric hypomotility. 75 Prokinetic effects of ghrelin have Ghrelin appears to mediate anti-inflammatory effects on IL-1, TNF, and IL-6 cytokine expression by T cells and mononuclear cells, while leptin appears to promote inflammatory cytokine expression.…”

Section: Effects Of Ghrelin On Appetite and Gastrointestinal Functionmentioning

confidence: 99%

Ghrelin in Critical Illness

Narula

deBoisblanc

2015

Am J Respir Cell Mol Biol

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Ghrelin, a recently described peptide, has attracted significant attention in recent years, primarily in the context of its endocrine- and appetite-regulating effects. The versatility of this peptide is manifested in a rapidly expanding body of literature highlighting its nonendocrine functions. This review summarizes the available data on the immunomodulatory as well as the non-immune-mediated effects of ghrelin that form the scientific basis of its role in critical illness.

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Effect of ICU interventions on gastrointestinal motility

Cited by 27 publications

References 42 publications

Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems

Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems

Nutrition risk assessment in the ICU

Ghrelin in Critical Illness

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