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BMC Pediatrics
Published in: BMC Pediatrics 1/2021

Open Access 01-12-2021 | Central Nervous System Trauma | Research article

Gastrointestinal failure score in children with traumatic brain injury

Authors: Ying Zhou, Weifeng Lu, Weibing Tang

Published in: BMC Pediatrics | Issue 1/2021

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Abstract

Background

To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function.

Methods

A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined.

Results

The percentage of patients with gastrointestinal dysfunction on the first day was 78.8 %. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4 and 21.8 % of the patients, respectively. The GIF score and mean GIF score for the first three days were significantly different between children with different degrees of TBI (P < 0.05); these scores were also significantly different between patients who died and those who survived (P < 0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio > 1, 95 % confidence interval = 1.457 to 16.016, P < 0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children.

Conclusions

The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.
Literature
1.
Hackenberg K, Unterberg A. [Traumatic brain injury]. Nervenarzt. 2016;87(2):203–14. quiz 215 – 206.PubMedCrossRef
2.
Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728–41.PubMedCrossRef
3.
Zhang LM, Li R, Sun WB, Wang XP, Qi MM, Bai Y, Bai J, Zheng WC. Low-Dose, Early Fresh Frozen Plasma Transfusion Therapy After Severe Trauma Brain Injury: A Clinical, Prospective, Randomized, Controlled Study. World Neurosurg. 2019;132:e21–7.PubMedCrossRef
4.
Marker S, Perner A, Wetterslev J, Krag M, Lange T, Wise MP, Borthwick M, Bendel S, Keus F, Guttormsen AB, et al. Pantoprazole prophylaxis in ICU patients with high severity of disease: a post hoc analysis of the placebo-controlled SUP-ICU trial. Intensive Care Med. 2019;45(5):609–18.PubMedCrossRef
5.
Vieira LV, Pedrosa LAC, Souza VS, Paula CA, Rocha R. Incidence of diarrhea and associated risk factors in patients with traumatic brain injury and enteral nutrition. Metab Brain Dis. 2018;33(5):1755–60.PubMedCrossRef
6.
Reintam Blaser A, Jakob SM, Starkopf J. Gastrointestinal failure in the ICU. Curr Opin Crit Care. 2016;22(2):128–41.PubMed
7.
Vredebregt SJ, Moll HA, Smit FJ, Verhoeven JJ. Recognizing critically ill children with a modified pediatric early warning score at the emergency department, a feasibility study. Eur J Pediatr. 2019;178(2):229–34.PubMedCrossRef
8.
Reintam A, Parm P, Kitus R, Starkopf J, Kern H. Gastrointestinal failure score in critically ill patients: a prospective observational study. Crit Care. 2008;12(4):R90.PubMedPubMedCentralCrossRef
9.
Bordejé ML, Montejo JC, Mateu ML, Solera M, Acosta JA, Juan M, García-Córdoba F, García-Martínez MA, Gastaldo R. Intra-Abdominal Pressure as a Marker of Enteral Nutrition Intolerance in Critically Ill Patients. The PIANE Study. Nutrients. 2019;11(11):2616–25.
10.
Agarwala R, Rana SS, Sharma R, Kang M, Gorsi U, Gupta R. Gastrointestinal Failure Is a Predictor of Poor Outcome in Patients with Acute Pancreatitis. Dig Dis Sci. 2020;65(8):2419–26.PubMedCrossRef
11.
Pan P, Song Y, Du X, Bai L, Hua X, Xiao Y, Yu X. Intestinal barrier dysfunction following traumatic brain injury. Neurol Sci. 2019;40(6):1105–10.PubMedCrossRef
12.
Kigerl KA, Mostacada K, Popovich PG. Gut Microbiota Are Disease-Modifying Factors After Traumatic Spinal Cord Injury. Neurotherapeutics. 2018;15(1):60–7.PubMedCrossRef
13.
Wang B, Wu G, Zhou Z, Dai Z, Sun Y, Ji Y, Li W, Wang W, Liu C, Han F, et al. Glutamine and intestinal barrier function. Amino Acids. 2015;47(10):2143–54.PubMedCrossRef
14.
Wang DC, Bose P, Parmer R, Thompson FJ. Chronic intrathecal baclofen treatment and withdrawal: I. Changes in ankle torque and hind limb posture in normal rats. J Neurotrauma. 2002;19(7):875–86.PubMedCrossRef
15.
Midenfjord I, Polster A, Sjövall H, Törnblom H, Simrén M. Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses. Neurogastroenterol Motil. 2019;31(8):e13619.PubMedCrossRef
16.
Reintam Blaser A, Malbrain ML, Starkopf J, Fruhwald S, Jakob SM, De Waele J, Braun JP, Poeze M, Spies C. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Med. 2012;38(3):384–94.PubMedPubMedCentralCrossRef
17.
Zhang D, Li Y, Ding L, Fu Y, Dong X, Li H. Prevalence and outcome of acute gastrointestinal injury in critically ill patients: A systematic review and meta-analysis. Med (Baltim). 2018;97(43):e12970.CrossRef
18.
Minhua C, Tao G, Fengchan X, Wenkui Y. Using Digestive Fluid Biomarkers to Predict Acute Gastrointestinal Injury in Critically Ill Patients: A Pilot Study. Am J Crit Care. 2018;27(6):504–7.PubMedCrossRef
19.
Ware AL, Shukla A, Goodrich-Hunsaker NJ, Lebel C, Wilde EA, Abildskov TJ, Bigler ED, Cohen DM, Mihalov LK, Bacevice A, et al. Post-acute white matter microstructure predicts post-acute and chronic post-concussive symptom severity following mild traumatic brain injury in children. Neuroimage Clin. 2020;25:102106.PubMedCrossRef
20.
Perceval C, Szajewska H, Indrio F, Weizman Z, Vandenplas Y. Prophylactic use of probiotics for gastrointestinal disorders in children. Lancet Child Adolesc Health. 2019;3(9):655–62.PubMedCrossRef
21.
Wesselink E, Koekkoek K, Looijen M, van Blokland DA, Witkamp RF, van Zanten ARH. Associations of hyperosmolar medications administered via nasogastric or nasoduodenal tubes and feeding adequacy, food intolerance and gastrointestinal complications amongst critically ill patients: A retrospective study. Clin Nutr ESPEN. 2018;25:78–86.PubMedCrossRef
22.
Aperstein Y, Cohen L, Bendavid I, Cohen J, Grozovsky E, Rotem T, Singer P. Improved ICU mortality prediction based on SOFA scores and gastrointestinal parameters. PLoS One. 2019;14(9):e0222599.PubMedPubMedCentralCrossRef
23.
Padar M, Starkopf J, Uusvel G, Reintam Blaser A. Gastrointestinal failure affects outcome of intensive care. J Crit Care. 2019;52:103–8.PubMedCrossRef
24.
Kansu A, Durmaz Ugurcan O, Arslan D, Unalp A, Celtik C, Sarıoglu AA. High-fibre enteral feeding results in improved anthropometrics and favourable gastrointestinal tolerance in malnourished children with growth failure. Acta Paediatr. 2018;107(6):1036–42.PubMedPubMedCentralCrossRef
25.
Mak MHW, Low JK, Junnarkar SP, Huey TCW, Shelat VG. A prospective validation of Sepsis-3 guidelines in acute hepatobiliary sepsis: qSOFA lacks sensitivity and SIRS criteria lacks specificity (Cohort Study). Int J Surg. 2019;72:71–7.PubMedCrossRef
26.
Liu Z, Meng Z, Li Y, Zhao J, Wu S, Gou S, Wu H. Prognostic accuracy of the serum lactate level, the SOFA score and the qSOFA score for mortality among adults with Sepsis. Scand J Trauma Resusc Emerg Med. 2019;27(1):51.PubMedPubMedCentralCrossRef
27.
Pereira B, Dorigatti A, Melek M, Dos Santos J, Ferreira M, Calderan T, Carmona C, Fraga G. Septic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome - a preliminary analysis. Anaesthesiol Intensive Ther. 2019;51(5):370–2.PubMedCrossRef
28.
Lu XL, Qiu J, Zhu YM, Chen P, Zuo C, Tang L, Liu X, Xiao ZH, Du YK. [Role of Pediatric Critical Illness Score in evaluating severity and prognosis of severe hand-foot-mouth disease]. Zhongguo Dang Dai Er Ke Za Zhi. 2015;17(9):961–4.PubMed
29.
Lu Y, Liu Z, Li S, Wang Y, Li C, Yuan E, Xing J, Guo W. [Nested case-control study on paediatric early warning score and ventilator-associated complications in children with acute respiratory distress syndrome]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019;44(9):996–1002.PubMed
30.
Lone NI, Lee R, Salisbury L, Donaghy E, Ramsay P, Rattray J, Walsh TS. Predicting risk of unplanned hospital readmission in survivors of critical illness: a population-level cohort study. Thorax. 2019;74(11):1046–54.PubMedCrossRef
Metadata
Title
Gastrointestinal failure score in children with traumatic brain injury
Authors
Ying Zhou
Weifeng Lu
Weibing Tang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-021-02673-5

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