Skip to main content
Log in

Gastrointestinales Versagen – Ernährung bei Reflux und Darmatonie

Nutrition (therapy) in gastrointestinal failure

  • Übersichten
  • Published:
Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Das Vorliegen einer gastrointestinalen Dysfunktion ist eine outcomerelevante Komplikation des kritisch kranken Patienten auf der ICU.

Ziel der Arbeit, Material und Methoden

Die folgende Übersichtsarbeit soll die Bedeutung einer gastrointestinalen Dysfunktion aufzeigen. Die multimodale Therapie einer Magenentleerungsstörung und eines paralytischen Ileus wird erörtert.

Ergebnisse

Erythromycin und Metoclopramid sind medikamentöse Therapieoptionen bei Magenentleerungsstörung, Neostigmin bei paralytischem Ileus.

Abstract

Background

The presence of gastrointestinal dysfunction is an outcome-relevant complication in critically ill ICU patients.

Aims, materials and methods

The following review aims to show the importance of gastrointestinal dysfunction. Multimodal therapy for gastroparesis and paralytic ileus is discussed.

Conclusion

Erythromycin and metoclopramide are options for gastroparesis, while neostigmine is commonly used for paralytic ileus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Reintam Blaser A et al (2020) Gastrointestinal dysfunction in the critically ill: a systematic scoping review and research agenda proposed by the section of metabolism, endocrinology and nutrition of the European society of intensive care medicine. Crit Care 24(1):224

    Article  PubMed  PubMed Central  Google Scholar 

  2. Reintam A et al (2008) Gastrointestinal failure score in critically ill patients: a prospective observational study. Crit Care 12(4):R90

    Article  PubMed  PubMed Central  Google Scholar 

  3. Reintam Blaser A et al (2021) Development of the gastrointestinal dysfunction score (GIDS) for critically ill patients—a prospective multicenter observational study (iSOFA study). Clin Nutr 40(8):4932–4940

    Article  CAS  PubMed  Google Scholar 

  4. Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32(9):920–924

    Article  CAS  PubMed  Google Scholar 

  5. Metheny NA et al (2008) Gastric residual volume and aspiration in critically ill patients receiving gastric feedings. Am J Crit Care 17(6):512–519 (quiz 520)

    Article  PubMed  PubMed Central  Google Scholar 

  6. Elke G et al (2019) Clinical nutrition in critical care medicine—guideline of the German society for nutritional medicine (DGEM). Clin Nutr ESPEN 33:220–275

    Article  PubMed  Google Scholar 

  7. Singer P et al (2019) ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 38(1):48–79

    Article  PubMed  Google Scholar 

  8. Yasuda H et al (2021) Monitoring of gastric residual volume during enteral nutrition. Cochrane Database Syst Rev 9(9):CD13335

    PubMed  Google Scholar 

  9. Kirkpatrick AW et al (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the world society of the abdominal compartment syndrome. Intensive Care Med 39(7):1190–1206

    Article  PubMed  PubMed Central  Google Scholar 

  10. Reintam Blaser A et al (2017) Early enteral nutrition in critically ill patients: ESICM clinical practice guidelines. Intensive Care Med 43(3):380–398

    Article  PubMed  PubMed Central  Google Scholar 

  11. Piton G, Capellier G (2016) Biomarkers of gut barrier failure in the ICU. Curr Opin Crit Care 22(2):152–160

    PubMed  Google Scholar 

  12. Piton G et al (2019) Impact of the route of nutrition on gut mucosa in ventilated adults with shock: an ancillary of the NUTRIREA-2 trial. Intensive Care Med 45(7):948–956

    Article  PubMed  Google Scholar 

  13. van der Spoel JI et al (2007) Laxation of critically ill patients with lactulose or polyethylene glycol: a two-center randomized, double-blind, placebo-controlled trial. Crit Care Med 35(12):2726–2731

    PubMed  Google Scholar 

  14. Reignier J et al (2018) Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet 391(10116):133–143

    Article  PubMed  Google Scholar 

  15. Fraipont V, Preiser JC (2013) Energy estimation and measurement in critically ill patients. Jpen J Parenter Enteral Nutr 37(6):705–713

    Article  PubMed  Google Scholar 

  16. Alkhawaja S et al Post-pyloric versus gastric tube feeding for preventing pneumonia and improving nutritional outcomes in critically ill adults. Cochrane Database Syst Rev 2015(8):CD8875

  17. Braun G, Muck A (2021) Endoscopy on the surgical intensive care unit. Anaesthesist 70(11):977–990

    Article  PubMed  Google Scholar 

  18. Smedley LW et al (2018) Safety and efficacy of intermittent bolus and continuous infusion neostigmine for acute colonic pseudo-obstruction. J Intensive Care Med (885066618809010)

  19. Cohen RB et al (2021) Timing of gastrografin administration in the management of adhesive small bowel obstruction (ASBO): does it matter? Surgery 170(2):596–602

    Article  PubMed  Google Scholar 

  20. Gotz M et al (2017) German society of gastroenterology, digestive and metabolic diseases (DGVS) position statement on endoscopic decompression in acute Ileus. Z Gastroenterol 55(12):1499–1508

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Georg Braun.

Ethics declarations

Interessenkonflikt

G. Braun gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

Michael Buerke, Siegen

Hinweis des Verlags

Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Braun, G. Gastrointestinales Versagen – Ernährung bei Reflux und Darmatonie. Med Klin Intensivmed Notfmed 119, 296–301 (2024). https://doi.org/10.1007/s00063-023-01082-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00063-023-01082-z

Schlüsselwörter

Keywords

Navigation