Reintam et al used the Gastrointestinal Failure (GIF) score to evaluate gastrointestinal function for patients in the intensive care unit (ICU). The authors are from the University of Tartu and multiple hospitals in Estonia and Germany.
Parameters:
(1) status of enteral feedings
(2) intra-abdominal pressures
Food intolerance is the inability to provide enteral feedings because of:
(1) diarrhea
(2) high gastric aspirate volume
(3) vomiting
(4) bowel distention
(5) obstruction
Sustained Intra-Abdominal Pressure (IAP)
New Organ Failure
Classification
< 12 mm Hg
NA
normal
>= 12 mm Hg
no
intra-abdominal hypertension (IAH)
> 20 mm Hg
yes
abdominal compartment syndrome (ACS)
where:
• There is a gap in the table for IAP 12-20 mm Hg and new organ failure.
Enteral Feeding
Intra-Abdominal Pressure
Points
normal
normal
0
< 50% of calculated needs OR no feeding at 3 days after abdominal surgery
normal
1
food intolerance
normal
2
normal or reduced
IAH
2
food intolerance
IAH
3
NA
abdominal compartment syndrome
4
Interpretation:
• A GIF score of 1 for >= 2 days indicates a patient at risk for gastrointestinal failure.
• A GIF score of 2 indicates gastrointestinal injury.
• A GIF score >= 3 during the first 3 days in the ICU is associated with higher ICU and 90 day mortalities.
• The GIF score can be used in conjunction with the SOFA score.
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