Perioperative gastrointestinal problems in the ICU

Anaesthesiol Intensive Ther. 2018;50(1):59-71. doi: 10.5603/AIT.a2017.0064. Epub 2017 Nov 20.

Abstract

Gastrointestinal (GI) problems after surgery are common and are not limited to patients undergoing abdominal surgery. GI function is complicated to monitor and is not included in organ dysfunction scores widely used in the ICUs. In most cases, it recovers after surgery, if systemic and local inflammation and perfusion improve, gut oedema resolves, and analgosedation is reduced. However, perioperative GI problems may have severe consequences and increase the risk of death if not recognized and managed in a timely manner. Careful risk evaluation followed by a complex structured assessment and appropriate management of GI symptoms should minimize the potentially severe consequences and thereby possibly improve outcome. In the current review, we summarize common non-specific perioperative GI problems and some specific surgery-related abdominal problems, address identification of patients at risk of GI problems, and give suggestions for perioperative GI management.

Keywords: abdominal problems; abdominal surgery; acute gastrointestinal injury; critical illness; gastrointestinal failure; gastrointestinal function; perioperative; postoperative.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Critical Care / methods*
  • Gastrointestinal Diseases / therapy*
  • Humans
  • Intensive Care Units*
  • Perioperative Care / methods*
  • Perioperative Period*