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Gastrointestinal complications in critically ill patients: what differs between adults and children?

Jesús López-Herce1

  • 1Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. pielvi@ya.com

Current Opinion in Clinical Nutrition and Metabolic Care
|February 10, 2009
PubMed

Insights

Gastrointestinal complications in critically ill patients are common and vary widely due to differing diagnostic criteria. Key risk factors include shock and certain medications, impacting enteral nutrition efficacy.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Pediatrics

Background:

  • Gastrointestinal complications are a significant concern in critically ill patients.
  • Variability in incidence and severity exists between pediatric and adult populations.
  • Enteral nutrition is crucial but can be hindered by these complications.

Purpose of the Study:

  • To analyze and compare causes, incidence, severity, and treatment of gastrointestinal complications in critically ill children and adults.
  • To review current literature on gastrointestinal issues in intensive care settings.
  • To identify risk factors and underlying mechanisms of these complications.

Main Methods:

  • Literature review and comparative analysis of existing studies.
  • Examination of incidence, causes, severity, and treatment strategies.
  • Focus on critically ill pediatric and adult populations.

Main Results:

  • Incidence data is highly variable due to lack of unified diagnostic criteria.
  • Gastrointestinal complications related to nutrition appear less frequent in children than adults.
  • Shock and drug administration (catecholamines, sedatives, muscle relaxants) are primary risk factors; altered motility underlies issues like gastric residue and constipation.

Conclusions:

  • Gastrointestinal complications impede enteral nutrition, potentially increasing morbidity and mortality.
  • Consensus on diagnostic criteria for gastric residues, constipation, and diarrhea is needed.
  • Further research should evaluate prokinetic agents, dietary interventions, and laxatives for managing motility disorders and constipation in critically ill patients.
Abstract

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