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Review
. 2025 Apr 1;31(2):172-178.
doi: 10.1097/MCC.0000000000001248. Epub 2025 Jan 29.

Assessing gastrointestinal system dysfunction in intensive care

Kaspar F Bachmann  1   2 , Varsha M Asrani  3   4 , Annika Reintam Blaser  1   5
Affiliations
Review

Assessing gastrointestinal system dysfunction in intensive care

Kaspar F Bachmann et al. Curr Opin Crit Care. .

Abstract

Purpose of review: To summarize the current knowledge on the assessment of gastrointestinal dysfunction.

Recent findings: Clinical assessment is becoming more structured but remains largely subjective. Some instrumental tools to assess gastrointestinal motility have been developed but not yet widely applied in clinical practice. Imaging techniques offer a good method for static (i.e. nonfunctional) diagnostics but a standardized dynamic assessment at the bedside is currently unavailable. Recent studies on biomarkers have not provided convincing results for accurate evaluation of gastrointestinal function.

Summary: Clinical assessment remains the main tool for assessing gastrointestinal dysfunction. A single sign or symptom does not reflect gastrointestinal dysfunction adequately, and a set of variables might be needed. Studies on tools reflecting gastrointestinal motility and biomarkers for response to enteral nutrients, including absorption, are warranted.

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References

    1. Reintam Blaser A, Malbrain ML, Starkopf J, et al. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Med 2012; 38:384–394.
    1. Reintam Blaser A, Preiser JC, Fruhwald S, et al. Working Group on Gastrointestinal Function within the Section of Metabolism, Endocrinology and Nutrition (MEN Section) of ESICM. 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 2020; 24:224.
    1. Bachmann KF, Jenkins B, Asrani V, et al. Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI). Crit Care 2024; 28:420.
    1. Kamath S, Hammad Altaq H, Abdo T. Management of sepsis and septic shock: what have we learned in the last two decades? Microorganisms 2023; 11:2231.
    1. Moreno R, Rhodes A, Piquilloud L, et al. The Sequential Organ Failure Assessment (SOFA) Score: has the time come for an update? Crit Care 2023; 27:15.

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