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Review
. 2020 Feb;44(2):182-196.
doi: 10.1002/jpen.1679. Epub 2019 Jul 26.

Gastrointestinal Dysfunction in Critical Illness: A Review of Scoring Tools

Varsha M Asrani  1   2 , Annabelle Brown  3 , Wei Huang  4 , Ian Bissett  1   5 , John A Windsor  1   5
Affiliations
Review

Gastrointestinal Dysfunction in Critical Illness: A Review of Scoring Tools

Varsha M Asrani et al. JPEN J Parenter Enteral Nutr. 2020 Feb.

Abstract

Gastrointestinal dysfunction/failure (GDF) is a common feature of critical illness. There is no consensus on the best way to measure severity of GDF. The aim of this systematic review was to evaluate and compare all gastrointestinal dysfunction scoring tools (GDSTs) to determine aspects that might be useful to construct a new gut scoring tool for intensive care patients. A comprehensive database search of MEDLINE and EMBASE on GDSTs in acute, surgical, and critically ill patients was conducted. Extraction of data was conducted for study characteristics, GDST domains, feasibility of the scoring process, clinical outcomes, and quality of life attributes; independent authors conducted the search, applied the selection criteria, and extracted the data. Methodological quality of studies was assessed. A GDST matrix was created using 14 scoring tools and was evaluated for validity. The 14 GDSTs identified were used in different clinical settings, including critical illness, acute intestinal failure, gastrointestinal disorders, and postoperative patients. There was marked variation between these GDSTs. There is a lack of emphasis in the use of objective laboratory parameters and gut-specific biomarkers to measure GDF in majority of the studies. The overall quality of evidence was poor, and most tools lacked formal validation. This review has highlighted the lack of an agreed and validated approach to scoring GDF in critical illness. The identified aspects of GDF relevant to critical illness should now be incorporated in a new scoring tool and prospectively tested in intensive care patients.

Keywords: critical illness; gastrointestinal dysfunction; gastrointestinal failure; scoring tools; systematic review.

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References

    1. McClave, SA, Sexton LK, Spain DA, Adams JL, Owens NA, Sullins MB. Enteral tube feeding in the intensive care unit: factors impeding adequate delivery. Crit Care Med. 1999;27(7):1252-1256.
    1. Singer P, Pichard C, Heidegger CP, Wernerman J. Considering energy deficit in the intensive care unit. Curr Opin Clin Nutr Metab Care. 2010;13(2):170-176.
    1. Debaveye Y, Van den Berghe G. Risks and benefits of nutritional support during critical illness. Annu Rev Nutr. 2006;26(26):513-538.
    1. Heidegger CP, Romand JA, Treggiari MM, Pichard C. Is it now time to promote mixed enteral and parenteral nutrition for the critically ill patient? Intensive Care Med. 2007;33(6):963-969.
    1. De Jonghe, B, Appere-De-Vechi C, Fournier M, et al. A prospective survey of nutritional support practices in intensive care unit patients: what is prescribed? What is delivered? Crit Care Med. 2001;29(1):8-12.

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