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Diarrhoea in the critically ill.

Patricia Wiesen1, André Van Gossum, Jean-Charles Preiser

  • 1Department of Intensive Care, Centre Hospitalier, Universitaire du Sart Tilman, Liège, Belgium.

Current Opinion in Critical Care
|March 18, 2006
PubMed
Summary
This summary is machine-generated.

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Diarrhoea is common in critically ill patients, especially during enteral feeding and antibiotic therapy. Management includes hydration, electrolyte replacement, and continuing enteral nutrition, with specific treatments for Clostridium difficile.

Area of Science:

  • Critical care medicine
  • Gastroenterology
  • Infectious diseases

Background:

  • Diarrhoea is a frequent complication in critically ill patients.
  • Specific challenges include diarrhoea in tube-fed patients and during antibiotic administration.
  • Understanding epidemiological data and management strategies is crucial.

Purpose of the Study:

  • To provide an updated review on diarrhoea in critically ill patients.
  • To discuss epidemiological aspects, focusing on tube feeding and antibiotic-associated diarrhoea.
  • To present current preventive and therapeutic measures.

Main Methods:

  • Literature review and synthesis of recent findings.
  • Emphasis on epidemiological data and clinical management.

Related Experiment Videos

  • Discussion of preventive strategies including dietary modifications and probiotics.
  • Main Results:

    • Continuous enteral feeding is associated with less diarrhoea than intermittent feeding.
    • Discontinuing enteral feeding during diarrhoea is not recommended.
    • Clostridium difficile-associated diarrhoea is common with quinolones and cephalosporins; fibre-enriched formulas and probiotics show promise.

    Conclusions:

    • Diarrhoea is prevalent in critically ill patients, particularly with sepsis, hypoalbuminemia, enteral feeding, and antibiotic use.
    • Management involves hydration, electrolyte balance, antidiarrheal agents, continued enteral feeding, and targeted antibiotics for C. difficile.
    • The roles of fibre-enriched formulas, prebiotics, and probiotics require further definition.