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The intensivist's assessment of gastrointestinal function: A pilot study

  • Varsha M. Asrani
    Correspondence
    Corresponding author at. Department of Critical Care Medicine, Auckland City Hospital, Surgical and Translational Research (STaR) Centre, Level 2, Department of Surgery, School of Medicine, University of Auckland, Building 507, 22-30 Park road, Grafton, Auckland, 1010, New Zealand. Tel.: +64 21 052 4353 (mobile).
    Affiliations
    Surgical and Translational Research (STaR) Centre, Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Department of Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand

    Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
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  • Colin McArthur
    Affiliations
    Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
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  • Ian Bissett
    Affiliations
    Surgical and Translational Research (STaR) Centre, Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
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  • John A. Windsor
    Affiliations
    Surgical and Translational Research (STaR) Centre, Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
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Published:December 10, 2021DOI:https://doi.org/10.1016/j.aucc.2021.10.008

      Abstract

      Gastrointestinal dysfunction/failure (GDF) is a common cause of concern in critically ill patients. Although the gut plays an important role in the genesis of organ failure, its exclusion from organ severity scoring systems has made it challenging for intensivists to score it sufficiently at the bedside. We aimed to survey intensive care specialists about their perceptions, attitudes, and approaches towards the assessment of the gut in Australia and New Zealand intensive care units (ICUs). An electronic (online) questionnaire was used to survey intensive care specialists from the Australia and New Zealand Intensive Care Society (ANZICS). The survey comprised 10 questions focused on four key areas: (i) the extent of the problem with GDF in ICUs, (ii) the use and reliability of the current gut scoring tools, (iii) personal approaches and practices associated with GDF assessment, and (4) potential value of a novel GDF scoring system and its incorporation into an organ severity score. Our results showed that GDF was a significant concern amongst ICUs in Australia and New Zealand intensivists (84%; 66/79), with a small number of participants (14%; 3/79) using a gut scoring tool in their ICUs. Despite this, we have no established objective scoring tool for its assessment. The survey highlighted the need for developing a novel scoring tool to assess the gut was considered important amongst majority of the intensivists (92%; 72/78), which would prove useful in clinical practice and potentially lead to incorporation into an organ severity score in the future.

      Keywords

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