Electrical Activity of the Gastrointestinal Tract in Critically Ill Patients

• Main Authors: E. V. Alekseeva, T. S. Popova, P. S. Salnikov, G. A. Baranov, I. N. Pachechnik
• Format: Article
• Language: Russian
• Published: Russian Academy of Medical Sciences 2013-10-01
• Series: Obŝaâ Reanimatologiâ
• Subjects: critical care; gastrointestinal tract; peripheral electrogastroenterography; glutamine.
• Online Access: https://www.reanimatology.com/rmt/article/view/99
• ISSN: 1813-9779; 2411-7110

Objective: to analyze changes in the electrical activity (EA) of the gastrointestinal tract (GIT) in critically ill patients and to evaluate its impact in clinics by using the effect of glutamine as an example. Subjects and methods. Examinations were made in 249 critically ill patients (131 men and 118 women at the age of 68±17 years), including 97 and 152 therapeutic and surgical patients, respectively. Two patient groups were identified: these included a control group (n=186) treated without glutamine therapy and a study group (n=63) additionally receiving glutamine 0.5 g/kg/day for 5 to 10 days (enterally or intravenously in relation to the magnitude of intestinal failure (IF)). The patients were automatically classified according to the values of GIT EA. The authors studied a relationship of the changes in the latter to APACHE II, SAPS II, SOFA, LOD, IF, and 28-day survival in the intensive care unit (ICU). The accuracy of probabilistic prediction was estimated, by simultaneously considering the status of seven organ systems and 28-day survival rates during the use of glutamine in relation to the scores of APACHE II and the type of GIT EA. Results. Two types of GIT EA were identified; these were moderate (type 1) and significant (type 2) changes as compared to the normal values. With an increase in the total severity of the condition and in the magnitude of IF regardless of the disease profile, there were unilateral GIT EA changes, their moderate and rather high correlation with APACHE II, SAPS II, SOFA, LOD scores, IF stage — with 28-day survival rates. The use of glutamine provided an increase in 28-day survival rates in patients with an APACHE II score of > 15 scores and type 2 GIT EA. Conclusion. The impairments of GIT EA in critical care patients possess specific pathological patterns an their account increases the accuracy of prediction and the efficacy of glutamine used in CCP. Key words: critical care, gastrointestinal tract, peripheral electrogastroenterography, glutamine.