Tutorial on Diarrhea and Enteral Nutrition: A Comprehensive Step-By-Step Approach

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Infectious Diseases

Background:

• Diarrhea in the intensive care unit (ICU) is a common yet often neglected issue.
• Its prevalence varies, and it is frequently misattributed to enteral nutrition, despite being multicausal.
• Complications include malnutrition, skin breakdown, infections, and prolonged hospital stays.

Purpose of the Study:

• To propose a comprehensive, step-by-step, multiprofessional therapeutic strategy for ICU diarrhea.
• To provide guidance on early, objective, and multimodal patient care.
• To address diagnosis and management of both general ICU diarrhea and Clostridium difficile infection-associated colitis.

Main Methods:

• A review of evidence published in the last 10 years from a PubMed database search.
• Development of a dynamic walkthrough guide for healthcare professionals.
• Inclusion of current recommendations for drug and supportive therapy.

Main Results:

• The tutorial outlines a structured approach to managing ICU diarrhea.
• It details diagnostic criteria and treatment protocols for general diarrhea and C. difficile colitis.
• Strategies for preventing and treating associated skin lesions are also provided.

Conclusions:

• A systematic and multimodal approach is crucial for optimizing the care of ICU patients with diarrhea.
• Addressing diarrhea proactively can mitigate complications, improve patient quality of life, and reduce hospital stay duration.
• This strategy aims to improve the management of a frequently overlooked critical care condition.