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Ten good reasons to consider gastrointestinal function after acute brain injury

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Abstract

The brain-gut axis represents a bidirectional communication linking brain function with the gastrointestinal (GI) system. This interaction comprises a top-down communication from the brain to the gut, and a bottom-up communication from the gut to the brain, including neural, endocrine, immune, and humoral signaling. Acute brain injury (ABI) can lead to systemic complications including GI dysfunction. Techniques for monitoring GI function are currently few, neglected, and many under investigation. The use of ultrasound could provide a measure of gastric emptying, bowel peristalsis, bowel diameter, bowel wall thickness and tissue perfusion. Despite novel biomarkers represent a limitation in clinical practice, intra-abdominal pressure (IAP) is easy-to-use and measurable at bedside. Increased IAP can be both cause and consequence of GI dysfunction, and it can influence cerebral perfusion pressure and intracranial pressure via physiological mechanisms. Here, we address ten good reasons to consider GI function in patients with ABI, highlighting the importance of its assessment in neurocritical care.

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Author notes

  1. Silvia De Rosa, Denise Battaglini, Juan Antonio Llompart-Pou and Daniel Agustin Godoy have equally contributed.

Authors and Affiliations

  1. Centre for Medical Sciences - CISMed, University of Trento, Via S. Maria Maddalena 1, 38122, Trento, Italy

    Silvia De Rosa

  2. Anesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS, Trento, Italy

    Silvia De Rosa

  3. UO Clinica Anestesiologica e Terapia Intensiva, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Denise Battaglini

  4. Servei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Spain

    Juan Antonio Llompart-Pou

  5. Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina

    Daniel Agustin Godoy

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  1. Silvia De Rosa
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Correspondence to Denise Battaglini.

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De Rosa, S., Battaglini, D., Llompart-Pou, J.A. et al. Ten good reasons to consider gastrointestinal function after acute brain injury. J Clin Monit Comput 38, 355–362 (2024). https://doi.org/10.1007/s10877-023-01050-0

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