Gastrointestinal motility, particularly in the stomach, is often impaired in critically ill patients receiving mechanical ventilation ( Dive..etal 1994). As many as 60 per cent of critically ill patients develop delayed or absent gastric motility as a result of drugs (particularly opioids and sedatives), sepsis, or their underlying disease.
With a true ileus it is impossible to feed enterally. However, true ileus is uncommon in the critically ill and is often stated to be present when there is simply gastric stasis. An ileus will occur if there is peritonitis—an indication for surgery.
Exogenous glucose utilization is impaired in trauma, sepsis, and multiple organ failure, indicating that in these situations there is a derangement of cellular metabolism.
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