Document Detail


Standardized concept for the treatment of gastrointestinal dysmotility in critically ill patients--current status and future options.
MedLine Citation:
PMID:  17933437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Inhibition of gastrointestinal motility is a major problem in critically ill patients. Motor stasis gives rise to subsequent complications including intolerance to enteral feeding, enhanced permeability of the atrophic intestinal mucosa and conditions as severe as systemic inflammatory response syndrome, sepsis and multiple organ failure. Although the diagnosis of motility disturbances in critically ill patients is difficult, the type and site of the disturbance are important to consider in the analysis of the condition and in the choice of therapeutic approach. The pharmacological treatment of impaired gastrointestinal motility is difficult to handle for the clinician, because the underlying mechanisms are complex and not fully understood and the availability of pharmacological treatment options is limited. In addition, there is a lack of controlled studies on which to build an evidence-based treatment concept for critically ill patients. Notwithstanding this situation, there has been remarkable progress in the understanding of the integrated regulation of gastrointestinal motility in health and disease. These advances, which largely relate to the organization of the enteric nervous system and its signaling mechanisms, enable the intensivist to develop a standardized concept for the use of prokinetic agents in the treatment of impaired gastrointestinal motility in critically ill patients.
Authors:
Michael K Herbert; Peter Holzer
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-10-22
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  27     ISSN:  1532-1983     ISO Abbreviation:  Clin Nutr     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-12     Completed Date:  2008-03-17     Revised Date:  2011-04-06    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  25-41     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University of Wuerzburg, Oberduerrbacher Str. 6, 97080 Wuerzburg, Germany. Herbert_M@klinik.uni-wuerzburg.de
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MeSH Terms
Descriptor/Qualifier:
Critical Illness*
Dietary Fiber / administration & dosage
Evidence-Based Medicine
Gastrointestinal Agents / therapeutic use*
Gastrointestinal Motility / drug effects*,  physiology*
Gastrointestinal Transit / drug effects,  physiology
Humans
Intestinal Diseases / prevention & control,  therapy*
Probiotics
Grant Support
ID/Acronym/Agency:
L 25-B05//Austrian Science Fund FWF
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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