The problem of gastric atony.

Normal gastrointestinal motility is crucial for maintaining an appropriate balance of microorganisms within the gut. Disruption of this system results in bacterial overgrowth and associated complications such as bacterial translocation, aspiration pneumonia, and sepsis. Critically ill animals are at increased risk of developing gastroparesis caused by primary gastrointestinal disturbances or severe metabolic derangements that impact gastrointestinal function. In the intensive-care setting, delayed gastric emptying complicates enteral nutrition, and the catabolic effects of severe illness further deplete the patient's caloric reserves, resulting in impaired wound healing, decreased immune function, and increased morbidity and mortality. The use of promotility drugs in critically ill patients is a safe, effective means to circumvent the problem of gastric atony and improve patient recovery. Understanding the drugs available and their interaction with the receptors involved in neuromuscular transmission within the gastrointestinal tract will aid the clinician in selecting the optimal prokinetic therapy.