Zusammenfassung
Hintergrund
Das Vorliegen einer gastrointestinalen Dysfunktion ist eine outcomerelevante Komplikation des kritisch kranken Patienten auf der ICU.
Ziel der Arbeit, Material und Methoden
Die folgende Übersichtsarbeit soll die Bedeutung einer gastrointestinalen Dysfunktion aufzeigen. Die multimodale Therapie einer Magenentleerungsstörung und eines paralytischen Ileus wird erörtert.
Ergebnisse
Erythromycin und Metoclopramid sind medikamentöse Therapieoptionen bei Magenentleerungsstörung, Neostigmin bei paralytischem Ileus.
Abstract
Background
The presence of gastrointestinal dysfunction is an outcome-relevant complication in critically ill ICU patients.
Aims, materials and methods
The following review aims to show the importance of gastrointestinal dysfunction. Multimodal therapy for gastroparesis and paralytic ileus is discussed.
Conclusion
Erythromycin and metoclopramide are options for gastroparesis, while neostigmine is commonly used for paralytic ileus.
Literatur
Reintam Blaser A et al (2020) Gastrointestinal dysfunction in the critically ill: a systematic sco** review and research agenda proposed by the section of metabolism, endocrinology and nutrition of the European society of intensive care medicine. Crit Care 24(1):224
Reintam A et al (2008) Gastrointestinal failure score in critically ill patients: a prospective observational study. Crit Care 12(4):R90
Reintam Blaser A et al (2021) Development of the gastrointestinal dysfunction score (GIDS) for critically ill patients—a prospective multicenter observational study (iSOFA study). Clin Nutr 40(8):4932–4940
Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32(9):920–924
Metheny NA et al (2008) Gastric residual volume and aspiration in critically ill patients receiving gastric feedings. Am J Crit Care 17(6):512–519 (quiz 520)
Elke G et al (2019) Clinical nutrition in critical care medicine—guideline of the German society for nutritional medicine (DGEM). Clin Nutr ESPEN 33:220–275
Singer P et al (2019) ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 38(1):48–79
Yasuda H et al (2021) Monitoring of gastric residual volume during enteral nutrition. Cochrane Database Syst Rev 9(9):CD13335
Kirkpatrick AW et al (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the world society of the abdominal compartment syndrome. Intensive Care Med 39(7):1190–1206
Reintam Blaser A et al (2017) Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med 43(3):380–398
Piton G, Capellier G (2016) Biomarkers of gut barrier failure in the ICU. Curr Opin Crit Care 22(2):152–160
Piton G et al (2019) Impact of the route of nutrition on gut mucosa in ventilated adults with shock: an ancillary of the NUTRIREA-2 trial. Intensive Care Med 45(7):948–956
van der Spoel JI et al (2007) Laxation of critically ill patients with lactulose or polyethylene glycol: a two-center randomized, double-blind, placebo-controlled trial. Crit Care Med 35(12):2726–2731
Reignier J et al (2018) Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet 391(10116):133–143
Fraipont V, Preiser JC (2013) Energy estimation and measurement in critically ill patients. Jpen J Parenter Enteral Nutr 37(6):705–713
Alkhawaja S et al Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults. Cochrane Database Syst Rev 2015(8):CD8875
Braun G, Muck A (2021) Endoscopy on the surgical intensive care unit. Anaesthesist 70(11):977–990
Smedley LW et al (2018) Safety and efficacy of intermittent bolus and continuous infusion neostigmine for acute colonic pseudo-obstruction. J Intensive Care Med (885066618809010)
Cohen RB et al (2021) Timing of gastrografin administration in the management of adhesive small bowel obstruction (ASBO): does it matter? Surgery 170(2):596–602
Gotz M et al (2017) German society of gastroenterology, digestive and metabolic diseases (DGVS) position statement on endoscopic decompression in acute Ileus. Z Gastroenterol 55(12):1499–1508
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
G. Braun gibt an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
Additional information
Redaktion
Michael Buerke, Siegen
Hinweis des Verlags
Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.
QR-Code scannen & Beitrag online lesen
Rights and permissions
About this article
Cite this article
Braun, G. Gastrointestinales Versagen – Ernährung bei Reflux und Darmatonie. Med Klin Intensivmed Notfmed 119, 296–301 (2024). https://doi.org/10.1007/s00063-023-01082-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00063-023-01082-z
Schlüsselwörter
- Gastrointestinale Dysfunktion
- Gastrales Residualvolumen
- Metoclopramid
- Neostigmin
- Endoskopische Dekompression