Gastrointestinal dysfunction in the critically ill: a systematic scoping review and research agenda proposed by the Section of Metabolism, Endocrinology and Nutrition of the European Society of Intensive Care Medicine.

Gastrointestinal (GI) dysfunction often occurs in critically ill but can be ignored as a result of lack of standardized diagnostic and therapeutic approaches. We aim to develop a research agenda for GI dysfunction for future research. We systematically the current knowledge on various subtopics of a particular viewpoint GI dysfunction, highlighted the remaining areas of uncertainty and suggested agenda of reviews scoping and systematic study of the future of studies.

This do the following steps in succession: (1) identify clinically important subtopics in the field GI function which ensures further research; (2) systematically reviewed the literature for each subtopic using PubMed, CENTRAL and the Cochrane Database of Systematic Reviews; (3) Evidence of summarizing for each subtopic; (4) identify areas of uncertainty; (5) formulates and flute studies that discuss the proposal this subtopics; and (6) a proposal to prioritize study through voting consecutive major rounds.Five themes identified: (1) monitoring, (2) the relationship between GI function and results, (3) GI function and nutrition, (4) management of GI dysfunction and (5 ) pathophysiological mechanisms.

Search in 17 subtopics conducted and evidence summarized. Some areas of uncertainty are identified, six of them require the consensus process. research proposals in the first rank among the top ten include: prevention and management of diarrhea; eating intolerance management above and below, including indications for a post-pyloric and opioid antagonist; Acute gastrointestinal injury levels as a bedside tool; intra-abdominal hypertension role in the development and monitoring of GI dysfunction and the development of non-occlusive mesenteric ischemia; and the effects of proton pump inhibitors on the microbiome in illness.

Current evidence critical of GI dysfunction rare, partly because of the lack of a precise definition. The use of a core set of monitoring and results needed to improve the consistency of future studies. We proposed several areas for the consensus process and research projects frontline.

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