摘要:

Intestinal angina, postprandial abdominal pain that causes patients to decrease their oral intake and lose weight, is diagnosed by mesenteric arteriography. Therapy, either angioplasty or revascularization, is indicated to prevent mesenteric infarction. In hypovolemia, gut perfusion is diminished early and returns slowly even after blood pressure is restored. Increased intra-abdominal pressure may cause an abdominal compartment syndrome leading to poor splanchnic perfusion. Surgeons may encounter this situation when trying to close the abdomen of certain patients. Experimental models of ischemia-reperfusion suggest that reperfusion may cause more gut damage than the initial ischemia. Antioxidant therapy seems to alternate the granulocyte activation, which may affect distant organs as well as the gut. Phospholipase A2inhibition may be effective up to 1 hour following reperfusion and seems to effectively prevent platelet activating factor(s) from activating neutrophils.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Ulcerative colitis and Crohn's disease are characterized by a chronic relapsing course, often requiring multiple medical and surgical interventions. Despite their chronicity, these conditions can present as true and potentially life-threatening gastrointestinal emergencies as well as extraintestinal emergencies. The successful management of such complications depends on early diagnosis and the judicious and timely use of both medical and surgical therapies.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Some authors claim that nutritional support is not efficacious in patients in intensive care. It is impossible, however, to demonstrate efficacy, because no medical ethical committee would accept a nontreatment group. In addition there are several other reasons why such a claim relies on misconceptions, which are discussed in this review. After the initial rise in the use of total parenteral nutrition during the 1970s, there is now increasing evidence that enteral nutrition is superior to parenteral nutrition, because in the latter a starving gut appears to lead to increased rates of infection. As a consequence, the proportion of patients receiving enteral nutrition has risen dramatically due to the use of pre- or postpyloric nutrition employing special feeding tubes inserted nasally, endoscopically, or perioperatively; the use of prokinetics; and cathartics. Immediate posttrauma or postoperative nutrition has not yet been proven to have additional benefits over nutritional support initiated 2 to 3 days after operation. Glutamine, a major intermediary metabolite in amino acid metabolism, has potential benefits in depleted patients or patients suffering from severe and long-term illness, especially with regard to gut barrier and immune function. Effects of glutamine enrichment in humans are conflicting with regard to immune function, but benefits with regard to the gut barrier function appear to be clear. Multimodality treatment with arginine, yeast RNA, and fish oil has yielded significant benefit with regard to the rate of infectious complications and the length of hospital stay in intensive care and postoperative patients. These results were not yet confirmed by other groups. Effects of hormonal modulation of metabolism with growth hormone and/or insulin-like growth factor on clinical outcome have not yet been described. Only growth hormone combined with glutamine and fiber added to the enteral diet appears to achieve benefits in patients with short-bowel syndrome.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This review focuses on the most recent studies of gastrointestinal disorders due to adverse reactions to drugs used in critical care, emphasizing topics relevant to clinicians. Gastrointestinal disorders are among the most common adverse reactions to drugs. Patients in critical care tend to be exposed to multiple medications and are vulnerable to adverse drug reactions. Every portion of the gastrointestinal tract is involved in adverse reactions to a number of medications. In critical care, gastroduodenal injuries induced by nonsteroidal anti-inflammatory drugs and antibiotic-associated colitis appear to be among the most significant drug-induced disorders of the gastrointestinal tract, just as in other clinical settings.

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1996

数据来源: OVID