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Gastrointestinal Issues in the Cardiothoracic ICU
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Author(s): Carrie Harvey (University of Michigan Health System, USA), Katherine Klein (University of Michigan Health System, USA)and Michael Maile (University of Michigan Health System, USA)
Copyright: 2015
Pages: 36
Source title:
Modern Concepts and Practices in Cardiothoracic Critical Care
Source Author(s)/Editor(s): Adam S. Evans (Icahn School of Medicine at Mount Sinai, USA), Gregory E. Kerr (Weill Cornell Medical College, USA), Insung Chung (Icahn School of Medicine at Mount Sinai, USA)and Robin Varghese (Icahn School of Medicine at Mount Sinai, USA)
DOI: 10.4018/978-1-4666-8603-8.ch018
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Abstract
A thorough understanding of gastrointestinal issues in critical illness is necessary to optimize management of the cardiothoracic patient. Post-operatively, these patients are at increased risk of GI complications due a combination of underlying vascular disease, cardiopulmonary bypass, and low cardiac output, all of which lead to splanchnic hypoperfusion and subsequent damage to the gut mucosa. While GI complications are uncommon, they are associated with a disproportionately high rate of morbidity and mortality. Presence of unexplained fever, leukocytosis, bacteremia, hemodynamic compromise or abdominal pain or distention are concerning and require prompt assessment. Other GI management issues include delivery of adequate nutrition to counteract catabolism and promote wound healing and stress ulcer prophylaxis in patients with risk factors for upper gastrointestinal bleeding.
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