• Cecilia I Loudet, María C Marchena, Leandro I Tumino, María L Cabana, Gabriela Capurro, Paulina Astegiano, Mariela A Velásquez, Matías Casanova, María J Rodríguez Bugueiro, María C Roth, Gisela Roda, Rolando Gimbernat, Yanina Del Valle Balmaceda, Patricia Okurzaty, Mario I Perman, Ana L González, Rosa Reina, and Elisa Estenssoro.
• Servicio de Terapia Intensiva, Hospital Interzonal General de Agudos General San Martín, La Plata, Argentina; Cátedra de Farmacología Aplicada, Universidad Nacional de La Plata, Argentina. Electronic address: cloudet@med.unlp.edu.ar.
• J Crit Care. 2020 Aug 1; 58: 41-47.

PurposeOur main objective was to use the Maximum Acute Gastrointestinal Injury Score (AGImax) to evaluate the prognostic capability of gastrointestinal dysfunction (GID), on hospital mortality in patients on mechanical ventilation (MV) requiring vasopressors. A secondary goal was to analyze the relationship between AGImax and vasopressor dosage with increasing caloric intake.Materials And MethodsProspective multicenter cohort study in ten ICUs across Argentina. Consecutive adult patients on MV, requiring vasopressors and receiving enteral nutrition (EN) were included. AGImax was identified (I-IV) using a modified AGI score. Comparisons of clinical and outcome variables were performed in 3 predetermined EN-groups: <10 kcal/kg/d, ≥10 to <20 kcal/kg/d, or ≥ 20 kcal/kg/d.ResultsA total of 494 patients met all inclusion criteria. Forty-four percent of patients had severe AGImax and 17% received <10 kcal/kg/day, indicating more severity and higher mortality. Notable independent predictors of mortality were AGImax, vasopressors, and caloric intake. PN was the only factor which had an inverse relationship to mortality.ConclusionsIn this population, patients with AGImax III-IV were significantly associated with lower caloric intake and greater hospital mortality, highlighting the importance of AGI as a prognostic tool. As PN was linked with lower mortality, it could be an option to explore in further studies.Copyright © 2020 Elsevier Inc. All rights reserved.

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