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: Waking up the gut in critically ill patients. | Meier Critical Care 2010 14 183 http content 14 5 183 CRITICAL CARE COMMENTARY L__ Waking up the gut in critically ill patients Juris J Meier See related review article by Deane etal. http content 14 5 228 Abstract Multiorgan failure frequently develops in critically ill patients. While therapeutic efforts in such patients are often focused on the lungs on the cardiovascular system as well as on the kidneys it is important to also consider the functional alterations in gut motility and hormone secretion. Given the central regulatory functions of many gut hormones such as glucagon-like peptide 1 glucagon-like peptide 2 ghrelin and others exogenous supplementation of some of these factors may be beneficial under conditions of critical illness. From a pragmatic point of view the most feasible way towards a restoration of gut hormone secretion in critically ill patients is to provide enteral nutritional supply as soon as possible. Multiorgan failure is a frequent complication in critically ill patients especially those suffering from systemic inflammatory syndromes 1 2 . The functional changes in the affected patients are known to affect primarily the lungs the cardiovascular system as well as the kidneys. While our therapeutic efforts have therefore often been focused on these organ systems it seems advisable to also include the gastrointestinal tract in the therapeutic management of critically ill patients 1 . Alterations in gastrointestinal motility are frequently found in such patients leading to disturbances in nutrient absorption induction of nausea and an increased risk of aspiration 1 . Furthermore the gut has long been established as an important immune barrier providing a safeguard against infectious complications 3 . For these reasons tight clinical monitoring of gastrointestinal motility is central in the clinical management of critically ill patients and the advantages of early enteral nutrition versus parenteral nutrient .
