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Constipation in intensive care unit: incidence and risk factors
Antonio Paulo Nassar1, Fernanda Maria Queiroz da Silva, Roberto de Cleva
1Department of Medicine, Discipline of Medical Emergencies, University of São Paulo, São Paulo, Brazil. paulo_nassar@yahoo.com.br
Insights
Constipation is highly prevalent in critically ill patients, affecting nearly 70%. Early enteral nutrition may help improve bowel function in these individuals.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Clinical Research
Background:
- Gastrointestinal motility disorders are frequent in critically ill patients.
- Constipation in this population is understudied, despite its potential impact.
Purpose of the Study:
- To determine the incidence of constipation in critically ill patients.
- To identify risk factors associated with constipation.
- To explore the implications of constipation in this patient group.
Main Methods:
- Prospective enrollment of intensive care unit (ICU) patients staying 3+ days over a 6-month period.
- Exclusion of patients who underwent bowel surgery.
- Analysis of patient demographics, clinical factors, and outcomes.
Main Results:
- Constipation incidence was 69.9% among critically ill patients.
- No significant differences in constipation rates based on sex, age, severity scores (APACHE II), admission type, opiate use, antibiotics, or mechanical ventilation.
- Early enteral nutrition (<24 hours) was significantly associated with reduced constipation (P < .01).
Conclusions:
- Constipation is a very common condition in critically ill patients.
- Early initiation of enteral nutrition is linked to an earlier return of bowel function.
Purpose:
Although gastrointestinal motility disorders are common in critically ill patients, constipation and its implications have received very little attention. We aimed to determine the incidence of constipation to find risk factors and its implications in critically ill patients
Materials And Methods:
During a 6-month period, we enrolled all patients admitted to an intensive care unit from an universitary hospital who stayed 3 or more days. Patients submitted to bowel surgery were excluded.
Results:
Constipation occurred in 69.9% of the patients. There was no difference between constipated and not constipated in terms of sex, age, Acute Physiology and Chronic Health Evaluation II, type of admission (surgical, clinical, or trauma), opiate use, antibiotic therapy, and mechanical ventilation. Early (<24 hours) enteral nutrition was associated with less constipation, a finding that persisted at multivariable analysis (P < .01). Constipation was not associated with greater intensive care unit or mortality, length of stay, or days free from mechanical ventilation.
Conclusions:
Constipation is very common among critically ill patients. Early enteral nutrition is associated with earlier return of bowel function.
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