Gastrointestinal Dysfunction During Enteral Nutrition in Critically Ill Patients
关键词
抽象
描述
Critical illness is typically associated with a catabolic stress state in which patients demonstrate a systemic inflammatory response coupled with complications of increased infectious morbidity, multiple organ dysfunction, prolonged hospitalization, and disproportionate mortality. Suspension of feeding and the resultant inability to reach nutritional goals is one complication of gastrointestinal (GI) dysfunction, but there are others (mucosal barrier disruption, altered motility, atrophy of the mucosa, and reduced mass of gut-associated lymphoid tissue) that may explain the greater length of stay (LOS) and death rate with GI dysfunction. In Europe and the United States, nutritional administration guidelines recommend primarily enteral nutrition (EN) for hemodynamically stable intensive care unit (ICU) patients. Providing EN in these patients has been shown to be superior to parenteral nutrition. GI complications such as constipation, delayed gastric emptying, diarrhea, and vomiting may occur in up to 50% of mechanically ventilated patients and adversely affect ICU mortality and LOS. Nevertheless, there is no consensus for obtaining a precise assessment of GI function.Diagnosis of GI dysfunction in ICU patients is complex and relies on clinical symptoms. Lack of validated markers of GI system dysfunction is often misdiagnosed and poorly managed in the ICU. The role of nutrition in critical illness is important, but there is an increasing evidence and broadening consensus that aggressive early feeding as well as prolonged underfeeding both should be avoided. Avoidance of complications like malnutrition, aspiration of gastric contents, wound infections, and decubitus through GI dysfunction is an important part of management of patients with GI failure.
日期
最后验证: | 06/30/2019 |
首次提交: | 07/03/2019 |
提交的预估入学人数: | 07/08/2019 |
首次发布: | 07/09/2019 |
上次提交的更新: | 07/08/2019 |
最近更新发布: | 07/09/2019 |
实际学习开始日期: | 12/31/2014 |
预计主要完成日期: | 06/30/2015 |
预计完成日期: | 06/30/2015 |
状况或疾病
干预/治疗
Other: MDR bacteria positivity
Other: negative fluid balance
相
手臂组
臂 | 干预/治疗 |
---|---|
Group I Patients who had GI dysfunction (Group I) for one or more occasions. | |
Group II Patients who had normal GI function (Group II) for one or more occasions. |
资格标准
有资格学习的年龄 | 18 Years 至 18 Years |
有资格学习的性别 | All |
取样方式 | Probability Sample |
接受健康志愿者 | 是 |
标准 | Inclusion Criteria: Older than 18 years old. Stay longer than 48 hours at ICU. Exclusion Criteria: Has enterostomy/colostomy or diagnosis of GI bleeding. Prone position. Laxative drug use. Clostridium Difficile infection positivity. |
结果
主要结果指标
1. The incidence of GI dysfunction [up to 14 days.]
次要成果指标
1. The sequential organ failure assessment(SOFA) score [at admission.]
2. Hypoalbuminemia [up to 14 days.]
3. Catecholamine use [up to 14 days.]
4. Length of hospital stay [through study completion, which is 6 months time period.]