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

Abstract:

PURPOSE OF REVIEW:The objective of this review has been to analyse and compare the causes, incidence, severity and treatment of gastrointestinal complications in critically ill children and adults. RECENT FINDINGS:The incidence of gastrointestinal complications in critically ill patients published in the literature is very variable owing to the absence of unified diagnostic criteria both in children and adults. The incidence of gastrointestinal complications related to nutrition appears to be lower in children than in adults, and there are no differences in the incidence of gastrointestinal complications between gastric and transpyloric nutrition except with respect to the volume of gastric residues. The most important risk factors for digestive tract complications are shock and the administration of drugs (catecholamines, sedatives and muscle relaxants). Altered gastrointestinal motility is the principal mechanism underlying an excessive gastric residue, abdominal distension and constipation. SUMMARY:Gastrointestinal complications limit the efficacy of enteral nutrition in the critically ill patient and can affect morbidity and mortality. Consensus must be reached on the definition of the criteria of excessive gastric residues, constipation and diarrhoea, and studies must be performed that evaluate the efficacy of prokinetic agents on altered gastrointestinal motility and the effects of diet and laxatives on constipation in the critically ill adult and child.

authors

López-Herce J

doi

10.1097/MCO.0b013e3283218285

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

180-5

issue

2

eissn

1363-1950

issn

1473-6519

pii

00075197-200903000-00014

journal_volume

12

pub_type

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