Gastrointestinal failure in intensive care: a retrospective clinical study in three different intensive care units in Germany and Estonia
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- 作者：Annika Reintam (1) (2)
Pille Parm (1)
Uwe Redlich (3)
Liina-Mai Tooding (2)
Joel Starkopf (1) (2)
Friedrich K?hler (4)
Claudia Spies (4)
Hartmut Kern (2) (3) (4) - 刊名：BMC Gastroenterology
- 出版年：2006
- 出版时间：December 2006
- 年：2006
- 卷：6
- 期：1
- 全文大小：531KB
- 参考文献：1. Wiest R, Rath HC: Bacterial translocation in the gut. / Best Practice & Research Clinical Gastroenterology 2003,17(3):397-25. 4-6">CrossRef
2. Galley HF, Ed: / Critical Care Focus 9 The Gut London: BMJ Books 2002.
3. Nieuwenhuijzen GAP, Deitch EA, Goris RJA: Infection, the Gut and the Development of the Multiple Organ Dysfunction Syndrome. / Eur J Surg 1996, 162:259-73.
4. Marino PL: / The ICU Book / 2 Edition Baltimore: Lippincott, Williams and Wilkins 1998.
5. Baue AE: History of MOF and Definitions of Organ Failure. / Multiple organ failure: pathophysiology, prevention and therapy / (Edited by: Baue AE, Faist E, Fry DE). New York: Springer-Verlag 2000, 3-3.
6. Goris RJA, te Bockhorst TPA, Nuytinck JKS, Gimbrere JSF: Multiple organ failure. / Arch Surg 1985, 120:1109-110.
7. Lefering R, Goris RJA, van Nieuwenhoven EJ, Neugebauer E: Revision of the multiple organ failure score. / Langenbeck's Arch Surg 2002, 387:14-0. 423-001-0269-3">CrossRef
8. Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S: Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. / Crit Care Med 1998,26(11):1767-.
9. Levy MM, Macias WL, Vincent JL, Russell JA, Silve E, Trzaskoma B, Williams MD: Early changes in organ function predict eventual survival in severe sepsis. / Crit Care Med 2005,33(10):2412-. CrossRef
10. Malbrain ML, Chiumello D, Pelosi P, / et al.: Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: A multiple-center epidemiological study. / Crit Care Med 2005,33(2):315-2. 408.09806.1B">CrossRef
11. Knaus WA, Draper EA, Wagner DP, Zimmerman JE: APACHE II: a severity of disease classification system. / Crit Care Med 1985,13(10):818-9. 46-198510000-00009">CrossRef
12. Hein OV, Birnbaum J, Wernecke K, England M, Konertz W, Spies C: Prolonged intensive care unit stay in cardiac surgery: risk factors and lon-term-survival. / Ann Thorac Surg 2006,81(39):880-. CrossRef
13. Hessel EA 2nd: Abdominal organ injury after cardiac surgery. / Semin Cardiothorac Vasc Anesth 2004,8(3):243-3. 400800306">CrossRef
14. Ishikawa S, Koyano T, Takahashi T, Sato Y, Hasegawa Y, Ohki S, Oshima K, Oki S, Kunimoto F, Morishita Y: What influences the results in critical patients after cardiovascular surgery? / Asian Cardiovasc Thorac Ann 2004,12(3):250-.
15. Reintam A, Parm P, Kern H, Starkopf J: Gastrointestinal failure and intraabdominal hypertension in medical and surgical patients. / Intensive Care Med 2005,31(Suppl 1):S125.
16. Ferreira FL, Bota DP, Bross A, Melot C, Vincent JL: Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients. / JAMA 2001,286(14):1754-758. 4.1754">CrossRef
17. Braun JP, Schroeder T, Buehner S, Dohmen P, Moshirzadeh M, Grosse J, Streit F, Schlaefke A, Armstrong VW, Oellrich M, Lochs H, Konertz W, Kox WJ, Spies C: Splanchnic oxygen transport, hepatic function and gastrointestinal barrier after normothermic cardiopulmonary bypass. / Acta Anaesthesiol Scand 2004,48(6):697-03. 4.00392.x">CrossRef
18. The pre-publication history for this paper can be accessed here:471-230X/6/19/prepub" class="a-plus-plus">http://www.biomedcentral.com/1471-230X/6/19/prepub - 作者单位：Annika Reintam (1) (2)
Pille Parm (1)
Uwe Redlich (3)
Liina-Mai Tooding (2)
Joel Starkopf (1) (2)
Friedrich K?hler (4)
Claudia Spies (4)
Hartmut Kern (2) (3) (4)
1. General Intensive Care Unit, Tartu University Clinics, Tartu, Estonia
2. Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia
3. Department of Anaesthesiology and Intensive Care, DRK Kliniken Berlin, Berlin, Germany
4. Department of Anaesthesiology and Intensive Care, Charité, Universit?tsmedizin Berlin, Berlin, Germany
文摘
Background While gastrointestinal problems are common in ICU patients with multiple organ failure, gastrointestinal failure has not been given the consideration other organ systems receive. The aim of this study was to evaluate the incidence of gastrointestinal failure (GIF), to identify its risk factors, and to determine its association with ICU mortality. Methods A retrospective analysis of adult patients (n = 2588) admitted to three different ICUs (two ICUs at the university hospital Charité-Universit?tsmedizin Berlin, Germany and one at Tartu University Clinics, Estonia) during the year 2002 was performed. Data recorded in a computerized database were used in Berlin. In Tartu, the data documented in the patients' charts was retrospectively transferred into a similar database. GIF was defined as documented gastrointestinal problems (food intolerance, gastrointestinal haemorrhage, and/or ileus) in the patient data at any period of their ICU stay. ICU mortality, length of stay, and duration of mechanical ventilation were assessed as outcome parameters. Results GIF was identified in 252 patients (9.7% of all patients). Only 20% of GIF patients were identifiable at admission. GIF was related to significantly higher mortality (43.7% vs. 5.3% in patients without GIF), as well as prolonged length of ICU stay (10 vs. 2 days) and mechanical ventilation (8 vs. 1 day), p < 0.001, respectively. Patients' profile (emergency surgical or medical), APACHE II and SOFA scores and the use of catecholamines at admission were identified as independent risk factors for the development of GIF. Development of GIF during ICU stay was an independent predictor for death. Conclusion Gastrointestinal failure represents a relevant clinical problem accompanied by an increased mortality, longer ICU stay and mechanical ventilation.