Gut failure: Diagnosis and management

Gatt, Marcel

Medicine
April 2008

Thesis or dissertation


Rights
© 2008 Marcel Gatt. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.
Abstract

Background: Inadequate gut function (IGF) or intestinal failure (IF) is common, particularly in surgical patients and the critically ill. It is difficult to measure objectively, and as a consequence its effects on outcome are contentious and treatment options are limited. Because of the gut's numerous homeostatic functions IF may predispose to delayed sepsis and multiorgan failure (MOF), eventually resulting in death.

Aim: To review the evidence regarding the clinical importance of IF, to define this phenomenon quantitatively, determine its effects, if any, on prognosis and to develop a therapy to treat it.

Conclusion: Adequacy of gut function can be defined quantitatively by enteral tolerance. Characterized in this way, IF is independently associated with prognosis, irrespective of other single organ failures and other determinants of outcome. GSN stimulate the return of gut function and this is associated with improved outcomes. Further research and the development of other gut-directed therapies are necessary.

Publisher
Postgraduate Medical Institute, The University of Hull
Qualification level
Doctoral
Qualification name
MD
Language
English
Extent
Filesize: NaNKB
Identifier
hull:1683
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