Nonhemorrhagic gastrointestinal complications in acute respiratory failure

While GI hemorrhage is a recognized complication of critical illness, nonhemorrhagic GI complications are less well described. We studied prospectively the incidence and predisposing factors of nonhemorrhagic GI complications in 124 acute respiratory failure (ARF) patients over a 13-month period. Diarrhea occurred in 51% (63/124), decreased bowel sounds in 50% (62/124), and abdominal distention in 46% (57/124). Patients with pneumonia as the etiology of respirator failure had the highest number of different complications (five per ICU stay). Ileus was found more frequently in patients with a past history of liver disease (p less than .03). Antacid administration was associated with a significant increase in diarrhea (p less than .01), as were the combined treatments of antacids and cimetidine (p less than .02). Patients with ARF have a high incidence of nonhemorrhagic GI complications. Diarrhea is the most common complication and occurs more frequently in patients who receive antacids.