Woosley Kristen P
Department of Emergency and Critical Care, The Bobst Hospital of The Animal Medical Center, New York, NY 10021, USA.
Clin Tech Small Anim Pract. 2004 Feb;19(1):43-8. doi: 10.1053/S1096-2867(03)00083-5.
Normal gastrointestinal motility is crucial for maintaining an appropriate balance of microorganisms within the gut. Disruption of this system results in bacterial overgrowth and associated complications such as bacterial translocation, aspiration pneumonia, and sepsis. Critically ill animals are at increased risk of developing gastroparesis caused by primary gastrointestinal disturbances or severe metabolic derangements that impact gastrointestinal function. In the intensive-care setting, delayed gastric emptying complicates enteral nutrition, and the catabolic effects of severe illness further deplete the patient's caloric reserves, resulting in impaired wound healing, decreased immune function, and increased morbidity and mortality. The use of promotility drugs in critically ill patients is a safe, effective means to circumvent the problem of gastric atony and improve patient recovery. Understanding the drugs available and their interaction with the receptors involved in neuromuscular transmission within the gastrointestinal tract will aid the clinician in selecting the optimal prokinetic therapy.
正常的胃肠蠕动对于维持肠道内微生物的适当平衡至关重要。该系统的破坏会导致细菌过度生长以及相关并发症，如细菌移位、吸入性肺炎和败血症。危重病动物因原发性胃肠功能紊乱或影响胃肠功能的严重代谢紊乱而发生胃轻瘫的风险增加。在重症监护环境中，胃排空延迟会使肠内营养复杂化，严重疾病的分解代谢作用会进一步消耗患者的热量储备，导致伤口愈合受损、免疫功能下降以及发病率和死亡率增加。在危重病患者中使用促动力药物是规避胃无力问题并改善患者康复的一种安全、有效的方法。了解可用药物及其与胃肠道神经肌肉传递中涉及的受体的相互作用将有助于临床医生选择最佳的促动力治疗方法。
