Postoperative gastrointestinal tract dysfunction: an overview of causes and management strategies.
Postoperative gastrointestinal (GI) tract dysfunction is common and has a complex, multifactorial pathogenesis. Perioperative administration of targeted amounts of fluid to optimize ventricular filling and end-organ perfusion has consistently been shown to improve mortality and other outcomes, particularly GI tract perfusion and function. The choice of fluid loading affects postoperative recovery, with colloid showing superiority over crystalloid, and lactated Ringer's solution proving better than normal saline. Other methods of reducing postoperative GI tract dysfunction with some proven degree of success include simple, low-cost interventions such as early initiation of oral feeding, early use of laxatives, and gum chewing. There is no evidence that prophylactic nasogastric decompression accelerates return of bowel function.
Mythen
Michael G Monty
MG
Centre for Anesthesia, Joint Biomedical Research Unit, NIHR Comprehensive Biomedical Research Centre, University College London Hospitals, London, United Kingdom. m.mythen@ich.ucl.ac.uk
D002302:Cardiac Output; D003102:Colloids / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors
D003102:Colloids