Gastrointestinal Failure score in critically ill patients: a prospective observational study

Reintam, Annika; Parm, Pille; Kitus, Reet; Starkopf, Joel; Kern, Hartmut

doi:10.1186/cc6958

Cited by 200 publications

(173 citation statements)

References 37 publications

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“…Indeed, the results suggest that patients with higher APACHE II scores are more vulnerable to IAP induced FI [114]. In many other studies, higher severity of illness scores have been reported in patients with IAH, as well as in patients with GI dysfunction and FI [4,19,20].…”

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 72%

“…A higher prevalence of feeding intolerance (FI) in patients with IAH has been demonstrated in several studies [4,114]. Bejarano et al [114] showed that baseline IAP together with an APACHE II score may predict FI.…”

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 99%

“…theoRy ii: Gi dysfuNctioN As A pARt of Mof Currently, the GI system is not included in the assessment of multiple organ dysfunction syndrome. The pathophysiological rationale and clinical data support the need incorporating GI dysfunction as a part of MOF [4,8].…”

Section: Fluid Management In Iah and Gi Dysfunctionmentioning

confidence: 99%

“…Even if not always easy at the bedside, it is usually possible to categorize organ function as normal or abnormal for most organ systems. At the same time, despite several efforts [4,5], evaluating gastrointestinal (GI) function in critically ill patients is not unified, and is still largely based on subjective clinical evaluation [6][7][8]. The term "Acute Gastrointestinal Injury" (AGI) has been recently proposed to describe GI dysfunction as a part of multiple organ failure (MOF) [7].…”

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confidence: 99%

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Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

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Evaluating the degree of organ dysfunction is a cornerstone in distinguishing patients with critical illness from those without. However, evaluation of the gastrointestinal function in critically ill patients is not unified, and is still largely based on subjective clinical evaluation. Although intra-abdominal pressure has been proposed as a parameter to facilitate monitoring of abdominal compartment in critical illness, the interactions between intra-abdominal pressure and gastrointestinal function are poorly clarified. The aim of this current review is to describe interactions and associations between gastrointestinal dysfunction and intra-abdominal pressure from a pathophysiological and clinical point of view.

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Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 72%

Section: Studies Connecting Iap and Clinical Symptoms Of Gi Dysfunctionmentioning

confidence: 99%

Section: Fluid Management In Iah and Gi Dysfunctionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

show abstract

“…It is also relevant to measure the IAP during enteral feeding. Feeding intolerance (daily caloric intake less than 500 kcal) can be caused by IAH [36]. On the other hand, studies showed, that there is only a marginal increase in IAP during enteral nutrition, and never in the range of ACS [8].…”

Section: Iah and Enteral Nutritionmentioning

confidence: 99%

Validation of a novel method for measuring intra-abdominal pressure and gastric residual volume in critically ill patients

Stappen¹,

Pigozzi²,

Tepaske³

et al. 2014

Anaesthesiol Intensive Ther

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Background: Gastric residual volume (GRV) can be measured in a variety of ways in critically ill patients, most often, the nasogastric tube is disconnected and the GRV is aspirated via a 60 mL syringe. Bladder pressure (IBP) measurement is the gold standard for intra-abdominal pressure (IAP) estimation. This study will look at the validation of a novel method combining measurement of GRV and estimation of IAP via intra-gastric pressure (IGP). Methods: In total 135 paired IAP and 146 paired GRV measurements were performed in 37 mechanically ventilated ICU patients. The IAP was estimated via the bladder (i.e. IBP) using the FoleyManometer and via the stomach (i.e. IGP) with the new device. The GRV was measured with the new device (GRV prototype ) and via the classic method (GRV classic ). The devices were provided by Holtech Medical (Charlottenlund, Denmark) and data were retrospectively analysed. Results: The number of paired measurements in each patient was 4 ± 1. The mean IBP was 10.7 ± 4.1 and mean IGP was 11.6 ± 4.1 mm Hg. Correlation between the IBP and IGP was significant, however moderate (R 2 = 0.51). Analysis according to Bland and Altman showed a bias and precision of 0.8 and 2.7 mm Hg respectively, however the limits of agreement (LA) were large and ranged from −4.5 to 6.1 mm Hg. Changes in IGP correlated well with changes in IBP. The median GRV prototype was 80 mL (0-1050) and equal to the median GRV classic of 80 mL (0−1250). Correlation between the 2 methods was excellent (R 2 = 0.89). Analysis according to Bland and Altman showed a bias and precision of -0.8 and 52.3 mL respectively and the LA ranged from -103 to 102 mL. Changes in GRV classic correlated well with changes in GRV prototype . Conclusions:The results of this multicentre pilot study show that GRV can be measured with the new device. Furthermore this allows simultaneous screening for intra-abdominal hypertension with IAP estimation via IGP.

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Prognostic Value of Prolonged Feeding Intolerance in Predicting All‐Cause Mortality in Critically Ill Patients: A Multicenter, Prospective, Observational Study

Yin

et al. 2019

J Parenter Enteral Nutr

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BackgroundThe 2012 European Society of Intensive Care Medicine (ESICM) guidelines provided a clear definition of feeding intolerance (FI). The study aimed to investigate the association between FI based on the current ESICM definition and clinical outcome and to further explore the effect of the duration of FI on mortality.MethodsAdult patients from 14 general intensive care units (ICUs) with an expected ICU stay ≥24 hours were prospectively studied. Based on FI duration in the first week of admission to the ICU, FI was categorized as 7‐day persistent feeding tolerance (FT), delayed FT, delayed FI, and 7‐day persistent FI. The primary outcomes were 28‐day and 60‐day all‐cause mortality.ResultsOf 499 patients, the prevalence of 3‐day and 7‐day persistent FI was 39.2% (n = 196) and 25.4% (n = 106), respectively. The patients with 3‐day FT had lower risk of 28‐day and 60‐day mortality rates and higher prevalence in ventilator weaning and vasoactive medication on the seventh day of ICU admission than those with 3‐day FI. Three‐day FI remained an independent predictor for 60‐day mortality. In a subgroup analysis including 418 patients with 7‐day survival, compared with those with 7‐day persistent FT, the odds ratios of 60‐day mortality were 1.67, 1.97, and 2.62 in the patients with delayed FT, delayed FI, and 7‐day persistent FI, respectively.ConclusionFI was associated with increased mortality and longer duration of mechanical ventilation and vasoactive support. Prolonged or relapsing FI represented an incremental risk of adverse outcomes in critically ill patients.

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Gastrointestinal Failure score in critically ill patients: a prospective observational study

Cited by 200 publications

References 37 publications

Abdominal pressure and gastrointestinal function: an inseparable couple?

Abdominal pressure and gastrointestinal function: an inseparable couple?

Validation of a novel method for measuring intra-abdominal pressure and gastric residual volume in critically ill patients

Prognostic Value of Prolonged Feeding Intolerance in Predicting All‐Cause Mortality in Critically Ill Patients: A Multicenter, Prospective, Observational Study

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