To Örebro University

Background: Gastrointestinal (GI) complications following cardiac surgery are infrequent but feared due to high morbidity and mortality. In 2012 new guidelines for grading acute GI injury (AGI score) in the intensive care setting were presented (1). We aimed to apply the AGI score in postoperative cardiac surgical patients.

Methods: A total number of 352 adult patients undergoing elective heart surgery with extra-corporeal circulation completed the study. Prospectively, AGI score was assessed daily during the first three post-operative days according to normal GI function (AGI 0), risk of developing GI dysfunction (AGI 1), GI dysfunction (AGI 2), GI failure (AGI 3) and GI failure with severe impact on distant organ function (AGI 4).

Results: Ninety-eight percent of the patients were assessed to have a daily peak score of ≤1, but only 36% were completely free from GI symptoms. Seven patients received a peak score of 2–3. The two patients with the highest peak and accumulated AGI scores died later due to GI complications.

Conclusions: Postoperative assessment of AGI score in cardiac surgical patients is feasible. A majority presented with a risk of developing GI dysfunction but did not progress further. Early postoperative GI dys-function might predispose for later GI complications, but a larger study population is needed to further investigate this association.

Reference:1. Reintam BA et al. Intens Care Med 2012; 38: 384–94.