Abstract OBJECTIVE: Gastrointestinal dysfunction often occurs in the clinical course of many critical illnesses. In order to explore the relationship between gastrointestinal dysfunction and critical illness and to study the role of inflammatory response in the development of gastrointestinal dysfunction and critical illness, this study examined the changes of TNF-α, IL-1β and IL-6 levels in critically ill children and made the regression analysis on systemic inflammatory response syndrome (SIRS), multiple organ failure (MOF), gastrointestinal dysfunction and death. METHODS: The medical data of 2 632 critically ill children admitted to the PICU of The Second Clinical Hospital, China Medical University between 2000 and 2003 were analyzed retrospectively. Logistic regression analysis was used to evaluate the relationship between SIRS classification and gastrointestinal dysfunction as well as the relationship of SIRS classification, MOF classification and gastrointestinal dysfunction with death. The Chi-square test was used to evaluate the relationship between gastrointestinal dysfunction and MOF classification. The levels of TNF-α, IL-1β and IL-6 were expressed as ±s. The Student T- test was used to evaluate the differences between groups. RESULTS: Logistic regression analysis showed that SIRS was a risk factor for gastrointestinal dysfunction (OR=4.711, P<0.05). The prevalence of MOF was not significantly associated with gastrointestinal dysfunction. A significant correlation was found between the number of involved organs in MOF and gastrointestinal dysfunction(χ2=75.6, P<0.05). SIRS classification, MOF classification and gastrointestinal dysfunction were all the risk factors for death(OR =19.642,58.252,63.800 respectively, all P<0.05). The levels of TNF-α, IL-1β and IL-6 in children with gastrointestinal dysfunction were significantly higher than in those without(90.51±3.32 ng/L vs 27.48±2.53 ng/L, 8.13±2.34 ng/L vs 6.03±1.81 ng/L,75.86±7.24 ng/L vs 10.96±2.24 ng/L, respectively, all P<0.05). CONCLUSIONS: Gastrointestinal dysfunction is closely related to critical illness. Cytokines may be involved in the development of gastrointestinal dysfunction. Early diagnosis and active intervention of gastrointestinal dysfunction are needed for children with critical illness.
