Division of Digestive Diseases, Bridgeport Hospital, Bridgeport, CT 06610, USA.
J Clin Gastroenterol. 2012 Jul;46(6):449-56. doi: 10.1097/MCG.0b013e31824e14c1.
Upper gastrointestinal (GI) dysmotility, an entity commonly found in the intensive care unit setting, can lead to insufficient nutrient intake while increasing the risk of infection and mortality. Further, overcoming the altered motility with early enteral feeding is associated with a reduced incidence of infectious complications in intensive care unit patients. Upper GI dysmotility in critical care patients is a common occurrence, and there are many causes for this problem, which affects a very heterogenous population with a multitude of underlying medical abnormalities. Therefore, it is of utmost importance to identify this widespread problem and subsequently institute a proper therapy as rapidly as possible. Prokinetic pharmacotherapies are currently the mainstay for the management of disordered upper GI motility. Future therapies, aimed at the underlying pathophysiology of this complex problem, are under investigation. These aim is to reduce the side effects of the currently available options, while improving on nutrition delivery in the critically ill. This review discusses the pathophysiology, clinical manifestations, diagnosis, and treatment of upper GI motility disturbances in the critically ill.
上消化道（GI）动力障碍是重症监护病房中常见的病症，它会导致营养摄入不足，增加感染和死亡的风险。此外，通过早期肠内喂养来克服异常的动力障碍与减少重症监护病房患者感染并发症的发生率有关。重症患者的上消化道动力障碍很常见，其有许多原因，影响着具有多种潜在医学异常的非常异质的人群。因此，识别这个普遍的问题并尽快进行适当的治疗至关重要。促动力药物治疗目前是治疗上消化道动力障碍的主要方法。针对这个复杂问题的潜在病理生理学的未来治疗方法正在研究中。这些方法旨在减少现有治疗方案的副作用，同时改善重症患者的营养供应。这篇综述讨论了重症患者上消化道动力障碍的病理生理学、临床表现、诊断和治疗。
