Cited by 119Gastrointestinal motility and disordersIntestinal and Peritoneal AdhesionsEnhanced Recovery After Surgery

Ileus in critical illness: mechanisms and management

Bauer, Anthony J., Schwarz, Nicolas T., Moore, Beverley A., T??rler, Andreas, Kalff, J??rg C.·2002·Current Opinion in Critical Care

Abstract

Nonobstructive ileus, signifying the impairment of coordinated propulsive intestinal motility, remains a frequently documented and almost inevitable consequence of open abdominal surgery and sepsis. Despite the frequency and major impact of ileus on morbidity and mortality, the exact underlying molecular and cellular mechanisms of this important clinical conundrum are still ill defined. Animal models suggest that both neuronal and local inflammatory responses within the intestinal muscularis mechanistically contribute to intestinal ileus. The neuronal mechanism appears to involve the enhanced release of nitric oxide from inhibitory motor neurons. Likewise, nitric oxide and prostaglandins are released from inflammatory cells (macrophages and monocytes) via the induction of nitric oxide synthase (iNOS) and cyclooxygenase-2. Recently, preliminary data have confirmed the existence of an intraoperative local muscularis inflammatory response during surgery in human patients.

Integrity signals

Registry

Crossref · 10.1097/00075198-200204000-00011

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70 of 70 references verified0 citation errors · 0 not checkable

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  • The pathogenesis of ileus is mediated by overproduction of cytokines in the bowel, which interferes with smooth muscle function.

    “The pathogenesis of ileus, a complication of abdominal surgery or trauma characterized by gastrointestinal hypomotility and delayed gastric emptying, is mediated by the overproduction of cytokines in the bowel, which interferes with smooth muscle function (48,49).”

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Authors
Bauer, A. J., Schwarz, N. T., Moore, B. A., T??rler, A., & Kalff, J. C.
Affiliations
  • University of Pittsburgh Medical Center (US)
  • University of Bonn (DE)
Corresponding author
  • Bauer, Anthony J.
  • Moore, Beverley A.
Venue
Current Opinion in Critical Care
Published
2002-04
Volume
8
Issue
2
Pages
152-157
ISSN
1070-5295 (ISSN-L)
OpenAlex
W1993079135
Cited by
119
References
70
Citations by year
2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 4 · 2014: 2 · 2013: 4 · 2012: 7
FWCI
1.59
Type
journal article
Language
en
Open access
closed
Locations
  • Current Opinion in Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of General Medical Sciences (P50 GM 53789, R01-GM-58241, P50GM053789, R01GM058241)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Keywords
critical illness, intestinal motility, sepsis, open abdominal surgery, nitric oxide, prostaglandins, nitric oxide synthase, cyclooxygenase-2, macrophages, monocytes, local inflammatory response, muscularis, motor neurons
MeSH terms
Endotoxins, Humans, Intestinal Obstruction, Macrophages, Nitric Oxide, Postoperative Complications, Sepsis, Inflammation Mediators, Neurogenic Inflammation

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