According to the severity of gastrointestinal dysfunction, gastrointestinal dysfunction (AGI) can be classified into four levels, each corresponding to different treatment measures:
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AGI Level I: There is a clear etiology leading to temporary partial gastrointestinal dysfunction, manifested as temporary and self-limiting, with the risk of gastrointestinal dysfunction and failure. For example: nausea and/or vomiting occurring early after abdominal surgery, disappearance of bowel sounds and reduced intestinal motility in early shock, etc.
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AGI Level II: The gastrointestinal tract shows inadequate digestion and absorption, failing to meet the body’s needs for nutrients and fluids. Gastrointestinal dysfunction can be rebuilt through clinical treatment. For example: gastroparesis with significant gastric retention or reflux, lower gastrointestinal paralysis, diarrhea, abdominal compartment syndrome Level I (IAP: 12-15mmHg), visible bleeding from gastric contents or stool, and feeding intolerance requiring decompression within 72 hours. Enteral feeding did not reach at least 83.72kJ/(kg·d) [20kcal/(kg·d)] target.
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AGI Level III: Loss of gastrointestinal function persists despite treatment, with significant gastric retention, continuous gastrointestinal paralysis, intestinal distension or deterioration, progression of intra-abdominal hypertension to Level II (IAP: 15-20mmHg), abdominal perfusion pressure (APP < 60mmHg), possibly associated with persistent or worsening multiple organ dysfunction syndrome (MODS). Gastrointestinal function remains unrecoverable, and general condition does not improve.
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AGI Level IV: Gastrointestinal failure accompanied by dysfunction of distant organs, significant worsening of gastrointestinal injury, exacerbating multiple organ failure and shock manifestations, even life-threatening. For example: gastrointestinal bleeding from ischemic necrosis leading to hemorrhagic shock, Ogilvie’s syndrome (pseudo-obstruction of the colon), abdominal compartment syndrome (ACS).
