Gastrointestinal Failure in Intensive Care Patients

Present dissertation is focused on evaluation of
gastrointestinal
function in intensive care patients. The definitions,
incidence and
impact of gastrointestinal failure are addressed.
Development of GI
symptoms is associated with increased mortality and
prolonged
ICU stay. The most remarkable raise in risk of death
may be
observed in
elective cardiosurgical patients. Similar to clinical
symptoms, the
incidence of intra-abdominal hypertension (IAH) is
high in mixed
ICU population. Monitoring the only the presumable
risk population
may result in missing part of the actual IAH
patients. The patients
with IAH have higher ICU- and 90-day mortality.
Secondary IAH
has worse outcome than primary IAH.
The scoring system for GIF based on combined
evaluation of
successfulness of enteral feeding and presence of
intra-abdominal
hypertension is developed. Proposed GIF score has
high prognostic
value in prediction of ICU mortality in single centre
prospective
study. Gastrointestinal failure assessed with GIF
score is highly
important among other organ failures in ICU.

Auteur
Annika Reintam was born in 1971 in Tartu, Estonia. She graduated the University of Tartu and became an intensive care doctor. She is currently working as a head of Department of Anaesthesiology and Intensive Care in East Tallinn Central Hospital. This dissertation for doctoral degree was supervised by professors Joel Starkopf and Hartmut Kern.

Texte du rabat
Present dissertation is focused on evaluation of gastrointestinal function in intensive care patients. The definitions, incidence and impact of gastrointestinal failure are addressed. Development of GI symptoms is associated with increased mortality and prolonged ICU stay. The most remarkable raise in risk of death may be observed in elective cardiosurgical patients. Similar to clinical symptoms, the incidence of intra-abdominal hypertension (IAH) is high in mixed ICU population. Monitoring the only the presumable risk population may result in missing part of the actual IAH patients. The patients with IAH have higher ICU- and 90-day mortality. Secondary IAH has worse outcome than primary IAH. The scoring system for GIF based on combined evaluation of successfulness of enteral feeding and presence of intra-abdominal hypertension is developed. Proposed GIF score has high prognostic value in prediction of ICU mortality in single centre prospective study. Gastrointestinal failure assessed with GIF score is highly important among other organ failures in ICU.