NDLI: Bench-to-bedside review: The gut as an endocrine organ in the critically ill

Content Provider	Springer Nature : BioMed Central
Author	Deane, Adam Chapman, Marianne J Fraser, Robert JL Horowitz, Michael
Abstract	In health, hormones secreted from the gastrointestinal tract have an important role in regulating gastrointestinal motility, glucose metabolism and immune function. Recent studies in the critically ill have established that the secretion of a number of these hormones is abnormal, which probably contributes to disordered gastrointestinal and metabolic function. Furthermore, manipulation of endogenous secretion, physiological replacement and supra-physiological treatment (pharmacological dosing) of these hormones are likely to be novel therapeutic targets in this group. Fasting ghrelin concentrations are reduced in the early phase of critical illness, and exogenous ghrelin is a potential therapy that could be used to accelerate gastric emptying and/or stimulate appetite. Motilin agonists, such as erythromycin, are effective gastrokinetic drugs in the critically ill. Cholecystokinin and peptide YY concentrations are elevated in both the fasting and postprandial states, and are likely to contribute to slow gastric emptying. Accordingly, there is a rationale for the therapeutic use of their antagonists. So-called incretin therapies (glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide) warrant evaluation in the management of hyperglycaemia in the critically ill. Exogenous glucagon-like peptide-2 (or its analogues) may be a potential therapy because of its intestinotropic properties.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc9039.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc9039
Journal	Critical Care
Issue Number	5
Volume Number	14
Language	English
Publisher	BioMed Central
Publisher Date	2010-09-24
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Gastric Emptying Critical Illness Gastroparesis Delayed Gastric Emptying Motilin
Content Type	Text
Resource Type	Review
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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