Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Bench-to-bedside review: The gut as an endocrine organ in the critically ill. | Deane et al. Critical Care 2010 14 228 http content 14 5 228 CRITICAL CARE REVIEW L_ Bench-to-bedside review The gut as an endocrine organ in the critically ill Adam Deane 1 2 3 Marianne J Chapman1 2 3 Robert JL Fraser3 4 5 and Michael Horowitz3 5 Abstract In health hormones secreted from the gastrointestinal tract have an important role in regulating gastrointestinal motility glucose metabolism and immune function. Recent studies in the critically ill have established that the secretion of a number of these hormones is abnormal which probably contributes to disordered gastrointestinal and metabolic function. Furthermore manipulation of endogenous secretion physiological replacement and supra-physiological treatment pharmacological dosing of these hormones are likely to be novel therapeutic targets in this group. Fasting ghrelin concentrations are reduced in the early phase of critical illness and exogenous ghrelin is a potential therapy that could be used to accelerate gastric emptying and or stimulate appetite. Motilin agonists such as erythromycin are effective gastrokinetic drugs in the critically ill. Cholecystokinin and peptide YY concentrations are elevated in both the fasting and postprandial states and are likely to contribute to slow gastric emptying. Accordingly there is a rationale for the therapeutic use of their antagonists. So-called incretin therapies glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide warrant evaluation in the management of hyperglycaemia in the critically ill. Exogenous glucagon-like peptide-2 or its analogues may be a potential therapy because of its intestinotropic properties. Introduction In health peptides released from the stomach and or intestine modulate motility secretion absorption mucosal growth and immune function of the gastrointestinal tract 1 . These hormones also have effects outside the gastrointestinal tract particularly in relation Correspondence .
