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Updated: Jul 16, 2026
08:15
Gastrointestinal Motility Monitor (GIMM)
Published on: December 1, 2010
Gastrointestinal motility and prokinetics in the critically ill
Marianne J Chapman1, Nam Q Nguyen, Robert J L Fraser
1Intensive Care Unit, Royal Adelaide Hospital, Adelaide, Australia. mchapman@mail.rah.sa.gov.au
Current Opinion in Critical Care
|March 1, 2007
Summary
Critically ill patients often experience gastrointestinal dysfunction, leading to failed enteral nutrition. Understanding these issues in upper gastrointestinal function is key to developing effective treatments for feed intolerance.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Physiology
Background:
- Enteral nutrition is crucial for critically ill patients but frequently fails due to gastrointestinal dysfunction.
- Current treatments for feed intolerance in critical illness are often inadequate.
Purpose of the Study:
- To review upper gastrointestinal function in health and critical illness.
- To summarize potential therapeutic options for gastrointestinal dysfunction in critical care.
Main Methods:
- Review of current literature on upper gastrointestinal physiology.
- Analysis of abnormalities in gastrointestinal motility and function during critical illness.
- Summary of existing and emerging therapeutic strategies.
Main Results:
- Critical illness impairs upper gastrointestinal function, including reduced lower esophageal sphincter tone, delayed gastric emptying, and abnormal duodenal motility.
- Nutrient administration exacerbates gastrointestinal dysfunction through enhanced enterogastric feedback and hormonal responses.
- Common prokinetic agents show limited efficacy due to rapid tachyphylaxis, necessitating novel therapeutic approaches.
- Reduced nutrient absorption occurs independently of gastric emptying issues.
Conclusions:
- Significant advancements have been made in understanding the mechanisms of feed intolerance in critical illness.
- Translating this understanding into effective therapeutic benefits remains a challenge.
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