scholarly journals Gastrointestinal symptoms in the ICU: a comparison of primary and secondary acute gastrointestinal injury

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
A Reintam Blaser ◽  
J Starkopf
Keyword(s):  
Gastrointestinal Symptoms ◽  
Gastrointestinal Injury ◽  
Acute Gastrointestinal Injury

Using Digestive Fluid Biomarkers to Predict Acute Gastrointestinal Injury in Critically Ill Patients: A Pilot Study

2018 ◽  
Vol 27 (6) ◽  
pp. 504-507
Author(s):  
Cheng Minhua ◽  
Gao Tao ◽  
Xi Fengchan ◽  
Yu Wenkui
Keyword(s):  
Intensive Care ◽  
Immunoglobulin A ◽  
Interleukin 10 ◽  
Secretory Immunoglobulin A ◽  
Gastrointestinal Injury ◽  
Gastrointestinal Failure ◽  
Acute Gastrointestinal Injury ◽  
Secretory Immunoglobulin ◽  
Grade Iii ◽  
Digestive Fluid

Background Acute gastrointestinal injury is associated with significantly increased mortality in critically ill patients. However, markers for measuring acute gastrointestinal injury are neither sensitive nor specific. Objective To determine whether enzymes in digestive fluid are predictive of the severity of acute gastrointestinal injury. Methods A prospective observational study was conducted between June 2015 and December 2015 in a surgical intensive care unit. Enrolled patients were classified by acute gastrointestinal injury grade according to the 2012 European Society of Intensive Care Medicine system. Digestive fluid was collected through nasointestinal tubes and analyzed 24 hours after the diagnosis of acute gastrointestinal injury. Intestinal markers of injury (pH, interleukin 6, interleukin 10, tumor necrosis factor α, and secretory immunoglobulin A) were measured in digestive fluid. Results Of the 76 patients included, acute gastrointestinal injury was grade I in 41, grade II in 20, grade III in 8, and grade IV in 7. Secretory immunoglobulin A was an independent predictor of grade III acute gastrointestinal injury. When data from patients with grades I and II injury and patients with grades III and IV injury were grouped together, analysis revealed that pH, interleukin 10, and secretory immunoglobulin A were independent predictors of acute gastrointestinal failure. Conclusions Secretory immunoglobulin A was predictive of grade III acute gastrointestinal injury. Digestive fluid markers of injury (pH, interleukin 10, and secretory immunoglobulin A) were predictors of acute gastrointestinal failure. Further study is required to determine if other markers are specific or sensitive for acute gastrointestinal injury.

scholarly journals Predictive value of transabdominal intestinal sonography in critically ill patients: a prospective observational study

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Tao Gao ◽  
Min-Hua Cheng ◽  
Feng-Chan Xi ◽  
Yan Chen ◽  
Chun Cao ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Characteristic Curve ◽  
Effective Means ◽  
Intestinal Wall ◽  
Feeding Intolerance ◽  
Gastrointestinal Injury ◽  
Increased Risk ◽  
Intestinal Peristalsis ◽  
Acute Gastrointestinal Injury

Abstract Background This study examined the feasibility of transabdominal intestinal ultrasonography in evaluating acute gastrointestinal injury (AGI). Methods A total of 116 patients were included. Intestinal ultrasonography was conducted daily within 1 week after admission to the intensive care unit. Ultrasonography indicators including intestinal diameter, changes in the intestinal folds, thickness of the intestinal wall, stratification of the intestinal wall, and intestinal peristalsis (movement of the intestinal contents) were observed to determine the acute gastrointestinal injury ultrasonography (AGIUS) score. The gastrointestinal and urinary tract sonography ultrasound (GUTS) protocol score was also calculated. During the first week of the study, the gastrointestinal failure (GIF) score was determined daily. The correlations between transabdominal intestinal scores (AGIUS and GUTS) and the GIF score were analyzed to clarify the feasibility of evaluating AGI through observation of the intestine. The utility of intestinal ultrasonography indicators in predicting feeding intolerance was investigated to improve the ability of clinicians to manage AGI. Results A total of 751 ultrasonic examinations were performed with 511 images (68%) considered to be of “good quality.” AGIUS and GUTS scores differed significantly between AGI patients (GIF score 0–2) and non-AGI patients (GIF score 3–4) (p < 0.001). Both scores correlated positively with GIF score (r = 0.54, p < 0.001; r = 0.66, p < 0.001). These ultrasonography indicators could predict feeding intolerance, with an area under the receiver operating characteristic curve of 0.60 (0.48–0.71; intestinal diameter), 0.76 (0.67–0.85; intestinal folds), 0.71 (0.62–0.80; wall thickness), 0.77 (0.69–0.86; wall stratification), and 0.78 (0.68–0.88; intestinal peristalsis). Compared to patients with a normal rate of peristalsis (5–10/min), patients with abnormal peristalsis rates (< 5/min or > 10/min) have increased risk for feeding intolerance (16/83 vs. 25/33, p < 0.001). Conclusions The transabdominal intestinal ultrasonography represents an effective means for assessing gastrointestinal injury in critically ill patients. Intestinal ultrasonography indicators, especially the degree of intestinal peristalsis, may be used to predict feeding intolerance. Trial registration ClinicalTrial.gov, NCT03589248. Registered 04 July 2018—retrospectively registered.

Association between nutrition support and acute gastrointestinal injury in critically ill patients during the first 72 hours

2021 ◽  
Vol 40 (1) ◽  
pp. 217-221
Author(s):  
Hongxiang Li ◽  
Junying Lu ◽  
Hongyan Li ◽  
Aosong Duan ◽  
Yushan Wang ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Gastrointestinal Injury ◽  
Acute Gastrointestinal Injury

scholarly journals Gut rest strategy and trophic feeding in the acute phase of critical illness with acute gastrointestinal injury

2019 ◽  
Vol 32 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Dong Zhang ◽  
Hongxiang Li ◽  
Yuting Li ◽  
Lai Qu
Keyword(s):  
Critical Illness ◽  
Critically Ill ◽  
Acute Phase ◽  
Critically Ill Patients ◽  
Gastrointestinal Dysfunction ◽  
Gastrointestinal Injury ◽  
Protective Strategy ◽  
Current Guidelines ◽  
Acute Gastrointestinal Injury ◽  
Trophic Feeding

AbstractCritically ill patients frequently suffer from gastrointestinal dysfunction as the intestine is a vulnerable organ. In critically ill patients who require nutritional support, the current guidelines recommend the use of enteral nutrition within 24–48 h and advancing towards optimal nutritional goals over the next 48–72 h; however, this may be contraindicated in patients with acute gastrointestinal injury because overuse of the gut in the acute phase of critical illness may have an adverse effect on the prognosis. We propose that trophic feeding after 72 h, as a partial gut rest strategy, should be provided to critically ill patients during the acute phase of illness as an organ-protective strategy, especially for those with acute gastrointestinal injury.

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