Surgical and Translational Research (STaR) Centre, Department of Surgery, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand; Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.
Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand.
Aust Crit Care. 2022 Nov;35(6):636-643. doi: 10.1016/j.aucc.2021.10.008. Epub 2021 Dec 10.
Gastrointestinal dysfunction/failure (GDF) is a common cause of concern in critically ill patients. Although the gut plays an important role in the genesis of organ failure, its exclusion from organ severity scoring systems has made it challenging for intensivists to score it sufficiently at the bedside. We aimed to survey intensive care specialists about their perceptions, attitudes, and approaches towards the assessment of the gut in Australia and New Zealand intensive care units (ICUs). An electronic (online) questionnaire was used to survey intensive care specialists from the Australia and New Zealand Intensive Care Society (ANZICS). The survey comprised 10 questions focused on four key areas: (i) the extent of the problem with GDF in ICUs, (ii) the use and reliability of the current gut scoring tools, (iii) personal approaches and practices associated with GDF assessment, and (4) potential value of a novel GDF scoring system and its incorporation into an organ severity score. Our results showed that GDF was a significant concern amongst ICUs in Australia and New Zealand intensivists (84%; 66/79), with a small number of participants (14%; 3/79) using a gut scoring tool in their ICUs. Despite this, we have no established objective scoring tool for its assessment. The survey highlighted the need for developing a novel scoring tool to assess the gut was considered important amongst majority of the intensivists (92%; 72/78), which would prove useful in clinical practice and potentially lead to incorporation into an organ severity score in the future.
胃肠道功能/衰竭(GDF)是危重症患者常见的关注点。尽管肠道在器官衰竭的发生中起着重要作用,但由于其在器官严重程度评分系统中被排除在外,使得重症监护医师在床边对其进行充分评分变得具有挑战性。我们旨在调查澳大利亚和新西兰重症监护单位(ICUs)的重症监护专家对肠道评估的看法、态度和方法。采用电子(在线)问卷对澳大利亚和新西兰重症监护学会(ANZICS)的重症监护专家进行调查。该调查包括 10 个问题,重点关注四个关键领域:(i)GDF 在 ICU 中的问题程度,(ii)当前肠道评分工具的使用和可靠性,(iii)与 GDF 评估相关的个人方法和实践,以及(4)新型 GDF 评分系统的潜在价值及其纳入器官严重程度评分。我们的结果表明,GDF 是澳大利亚和新西兰重症监护医师关注的 ICU 中的一个重要问题(84%;66/79),只有少数参与者(14%;3/79)在其 ICU 中使用肠道评分工具。尽管如此,我们仍然没有用于评估其的既定客观评分工具。该调查强调需要开发一种新型评分工具来评估肠道,这被大多数重症监护医师认为很重要(92%;72/78),这将在临床实践中证明有用,并有可能在未来纳入器官严重程度评分。