Khilnani Praveen, Rawal Nidhi, Singha Chandrasekhar
Pediatric Intensive Care Unit, Madhukar Rainbow Children's Hospital, New Delhi, India.
Indian J Crit Care Med. 2020 Sep;24(Suppl 4):S201-S204. doi: 10.5005/jp-journals-10071-23637.
Due to lack of uniform diagnostic criteria, gastrointestinal (GI) complications in critically ill occur with variable frequency, and overall incidence of such complications seems to be less in children compared to adults. Major risk factors are use of catecholamines, sedatives, and muscle relaxants in patients with shock. GI dysmotility in critically ill patients is the main reason behind abdominal distension, increased gastric residual volume, and constipation. GI bleeding is described in about 10% of patients with critical illness with about 1.6% have clinically significant bleeding, particularly in patients with coagulopathy, respiratory failure, or PRISM scores >10. In this review, the most common GI issues encountered in children will be discussed as mentioned earlier. In addition management of acute GI bleeding will also be discussed. Khilnani P, Rawal N, Singha C. Gastrointestinal Issues in Critically Ill Children. Indian J Crit Care Med 2020;24(Suppl 4):S201-S204.
由于缺乏统一的诊断标准,危重症患者胃肠道(GI)并发症的发生频率不一,而且此类并发症在儿童中的总体发生率似乎低于成人。主要危险因素是休克患者使用儿茶酚胺、镇静剂和肌肉松弛剂。危重症患者的胃肠动力障碍是腹胀、胃残余量增加和便秘的主要原因。约10%的危重症患者会出现胃肠道出血,其中约1.6%有临床显著出血,特别是在患有凝血病、呼吸衰竭或儿科风险评估系统(PRISM)评分>10的患者中。在本综述中,如前所述,将讨论儿童中最常见的胃肠道问题。此外,还将讨论急性胃肠道出血的管理。Khilnani P,Rawal N,Singha C。危重症儿童的胃肠道问题。《印度危重症医学杂志》2020年;24(增刊4):S201-S204。