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Gastrointestinal dysfunction among intensive care unit patients.

R W Chang1, S Jacobs, B Lee

  • 1Department of Surgery, Riyadh Armed Forces Hospital, Saudi Arabia.

Critical Care Medicine
|October 1, 1987
PubMed
Summary
This summary is machine-generated.

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Gastrointestinal dysfunction, defined as the inability to tolerate enteral nutrition (EN), significantly increases hospital mortality in ICU patients. Early identification of GI dysfunction is crucial for improving patient prognosis and outcomes.

Area of Science:

  • Critical Care Medicine
  • Gastroenterology
  • Prognostic Factor Analysis

Background:

  • Gastrointestinal (GI) dysfunction is common in intensive care unit (ICU) patients.
  • Failure to tolerate enteral nutrition (EN) is a clinical indicator of GI dysfunction.
  • The prognostic significance of GI dysfunction in ICU settings requires further evaluation.

Purpose of the Study:

  • To assess the prognostic importance of GI dysfunction, defined as EN intolerance, in ICU patients.
  • To compare mortality rates between ICU patients with and without GI dysfunction.
  • To identify factors associated with GI dysfunction and its impact on patient outcomes.

Main Methods:

  • Utilized the Acute Physiological and Chronic Health Evaluation (APACHE II) system to stratify patient risk.

Related Experiment Videos

  • Compared two groups of ICU patients: 111 tolerating EN (functioning gut) and 97 on total parenteral nutrition (TPN) due to EN intolerance (GI dysfunction).
  • Analyzed differences in APACHE II scores, including mean blood pressure, oxygenation, and creatinine levels, between the groups.

    • Main Results:

    • Patients with GI dysfunction (TPN group) exhibited significantly higher hospital mortality (51%) compared to those with a functioning gut (EN group, 25%) (p < .0005).
    • GI dysfunction was associated with poorer APACHE II scores in mean blood pressure, oxygenation, and creatinine.
    • Factors like shock, ischemia, and hypoxemia may contribute to GI dysfunction and negatively impact prognosis.

    Conclusions:

    • GI dysfunction, indicated by EN intolerance, is a significant independent risk factor for increased mortality in ICU patients.
    • Clinical manifestations of GI tract changes due to critical illness (e.g., shock, ischemia, hypoxemia) can adversely affect prognosis.
    • Recognizing and managing GI dysfunction is essential for improving outcomes in critically ill patients.