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Constipation in a cohort prospective in adult critically ill patients: How much occurs and why?
1Postgraduate Program in Nursing, Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil; Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil.
Objective:
To assess the incidence and factors associated with constipation in adult critical care patients.
Design:
Prospective cohort study.
Setting:
Intensive care unit (ICU) of a high-complexity hospital from November 2015 to October 2016.
Patients:
Adults who were hospitalized for at least 72h in the ICU were followed from their admission to the ICU until their departure.
Interventions:
None.
Measurements And Main Results:
In the 157 patients followed up, the incidence of constipation was 75.8%. The univariate analysis showed that constipated patients were younger, used more sedation and showed more respiratory and postoperative causes for hospitalization, while non-constipated patients were hospitalized more for gastrointestinal reasons. The use of vasoactive substances, mechanical ventilation and haemodialysis was similar between the constipated and non-constipated patients. Multivariate analysis, days of use of docusate+bisacodyl (HR: .79; 95% CI: .65-.96) of omeprazole or ranitidine (HR: .80; 95%CI: .73-.88) and lactulose (HR: .87; 95%CI: .76-.99) were independent protection factors for constipation.
Conclusion:
Constipation has a high incidence among adult critical care patients. Days of drug use acting on the digestive tract (lactulose, docusate+bisacodyl and omeprazole and/or ranitidine) are able to prevent this outcome.
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