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Tytuł pozycji:

Predictive value of transabdominal intestinal sonography in critically ill patients: a prospective observational study.

Tytuł:
Predictive value of transabdominal intestinal sonography in critically ill patients: a prospective observational study.
Autorzy:
Gao T; Research Institute of General Surgery, Jinling Hospital affiliated to Nanjing University Medical School, No.305, Zhongshan East Road, Nanjing, People's Republic of China.
Cheng MH; Department of Intensive Care Unit, Drum Tower Hospital affiliated to Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, People's Republic of China.
Xi FC; Research Institute of General Surgery, Jinling Hospital affiliated to Nanjing University Medical School, No.305, Zhongshan East Road, Nanjing, People's Republic of China.
Chen Y; Department of Intensive Care Unit, Drum Tower Hospital affiliated to Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, People's Republic of China.
Cao C; Department of Intensive Care Unit, Drum Tower Hospital affiliated to Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, People's Republic of China.
Su T; Department of Intensive Care Unit, Drum Tower Hospital affiliated to Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, People's Republic of China.
Li WQ; Research Institute of General Surgery, Jinling Hospital affiliated to Nanjing University Medical School, No.305, Zhongshan East Road, Nanjing, People's Republic of China.
Yu WK; Department of Intensive Care Unit, Drum Tower Hospital affiliated to Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, People's Republic of China. .
Źródło:
Critical care (London, England) [Crit Care] 2019 Nov 27; Vol. 23 (1), pp. 378. Date of Electronic Publication: 2019 Nov 27.
Typ publikacji:
Journal Article; Observational Study
Język:
English
Imprint Name(s):
Publication: London, UK : BioMed Central Ltd
Original Publication: London : Current Science Ltd, c1997-
MeSH Terms:
Predictive Value of Tests*
Abdominal Injuries/*classification
Gastrointestinal Tract/*diagnostic imaging
Ultrasonography/*standards
APACHE ; Abdominal Injuries/diagnosis ; Adult ; Aged ; China ; Critical Illness/therapy ; Female ; Gastrointestinal Tract/physiopathology ; Hospitalization/statistics & numerical data ; Humans ; Intensive Care Units/organization & administration ; Intensive Care Units/statistics & numerical data ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Point-of-Care Systems ; Prospective Studies ; ROC Curve ; Ultrasonography/methods ; Ultrasonography/statistics & numerical data
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Grant Information:
ZDRCA2016099 International "the 13th Five-Year Plan" Foundation of Jiangsu Province for Medical Key Talents
Contributed Indexing:
Keywords: Abdominal hypertension; Abdominal pressure; Acute gastrointestinal injury; GUTS protocol; POCUS; Ultrasound
Molecular Sequence:
ClinicalTrials.gov NCT03589248
Entry Date(s):
Date Created: 20191129 Date Completed: 20200504 Latest Revision: 20200505
Update Code:
20240104
PubMed Central ID:
PMC6880579
DOI:
10.1186/s13054-019-2645-9
PMID:
31775838
Czasopismo naukowe
Background: This study examined the feasibility of transabdominal intestinal ultrasonography in evaluating acute gastrointestinal injury (AGI).
Methods: A total of 116 patients were included. Intestinal ultrasonography was conducted daily within 1 week after admission to the intensive care unit. Ultrasonography indicators including intestinal diameter, changes in the intestinal folds, thickness of the intestinal wall, stratification of the intestinal wall, and intestinal peristalsis (movement of the intestinal contents) were observed to determine the acute gastrointestinal injury ultrasonography (AGIUS) score. The gastrointestinal and urinary tract sonography ultrasound (GUTS) protocol score was also calculated. During the first week of the study, the gastrointestinal failure (GIF) score was determined daily. The correlations between transabdominal intestinal scores (AGIUS and GUTS) and the GIF score were analyzed to clarify the feasibility of evaluating AGI through observation of the intestine. The utility of intestinal ultrasonography indicators in predicting feeding intolerance was investigated to improve the ability of clinicians to manage AGI.
Results: A total of 751 ultrasonic examinations were performed with 511 images (68%) considered to be of "good quality." AGIUS and GUTS scores differed significantly between AGI patients (GIF score 0-2) and non-AGI patients (GIF score 3-4) (p < 0.001). Both scores correlated positively with GIF score (r = 0.54, p < 0.001; r = 0.66, p < 0.001). These ultrasonography indicators could predict feeding intolerance, with an area under the receiver operating characteristic curve of 0.60 (0.48-0.71; intestinal diameter), 0.76 (0.67-0.85; intestinal folds), 0.71 (0.62-0.80; wall thickness), 0.77 (0.69-0.86; wall stratification), and 0.78 (0.68-0.88; intestinal peristalsis). Compared to patients with a normal rate of peristalsis (5-10/min), patients with abnormal peristalsis rates (< 5/min or > 10/min) have increased risk for feeding intolerance (16/83 vs. 25/33, p < 0.001).
Conclusions: The transabdominal intestinal ultrasonography represents an effective means for assessing gastrointestinal injury in critically ill patients. Intestinal ultrasonography indicators, especially the degree of intestinal peristalsis, may be used to predict feeding intolerance.
Trial Registration: ClinicalTrial.gov, NCT03589248. Registered 04 July 2018-retrospectively registered.

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