By Intensive Care Society Staff
This factor of the serious care concentration sequence addresses concerns with regards to gastro-intestinal platforms correct to seriously ailing sufferers at the in depth Care Unit. It comprises chapters in acute pancreatis, diarrohea, intestine finction in the course of enteral feeding, administration of fistulae and haemorrhage and the physiology/pathoplogy of mesenteric ischaemia. furthermore, the function of the intestine within the improvement of distant organ failure is mentioned.
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Extra info for Critical Care Focus 9: Gut
5). Suppression was shown to be a consequence of the release of a soluble suppressive factor from splenic adherent cells. The stimulus for the release of this factor was not endotoxin, but a second factor released from the liver. 5 In vitro incorporation of 3H thymidine in Concanavalin A stimulated splenocytes from rats infused with killed Pseudomonas aeruginosa into either inferior vena cava (IVC) or the portal vein (PV) or systemically (S). Boxes are the mean of 10 replicate experiments. Reproduced with permission from Marshall JC, et al.
Some novel therapeutic approaches have suggested possibilities for the future. References 1 Bliss DZ, Guenter PA, Settle RG. Defining and reporting diarrhea in tube-fed patients – what a mess! Am J Clin Nutr 1992;55:753–9. 2 Guenter PA, Sweed MR. A valid and reliable tool to quantify stool output in tube-fed patients. J Parenter Enteral Nutr 1998;22:147–51. 3 Mitra AK, Rahman MM, Fuchs GJ. Risk factors and gender differentials for death among children hospitalized with diarrhoea in Bangladesh. J Health Popul Nutr 2000;18:151–6.
Thus moderately mild reductions in intestinal perfusion pressure and/or blood flow cause little evidence of injury. Ischaemic bowel disease occurs more often in the elderly since in older patients the vascular supply can frequently be compromised. The clinical 42 MESENTERIC ISCHAEMIA manifestations are varied, depending on the site of vascular occlusion and the extent of the resulting bowel necrosis. Mesenteric vasculature The blood flow to the splanchnic organs is derived from three main arterial trunks, the coeliac artery, the superior mesenteric artery and the inferior mesenteric artery.