The incidence and risk factors of gastrointestinal dysfunction during enteral nutrition in mechanically ventilated critically ill patients.

Autor: Shi L; Huizhou Central People's Hospital, Huizhou, Guangdong, China., Shao J; The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China., Luo Y; Huizhou Central People's Hospital, Huizhou, Guangdong, China., Liu G; Huizhou Central People's Hospital, Huizhou, Guangdong, China., OuYang M; Huizhou Central People's Hospital, Huizhou, Guangdong, China.
Jazyk: angličtina
Zdroj: Nursing open [Nurs Open] 2024 Nov; Vol. 11 (11), pp. e2247.
DOI: 10.1002/nop2.2247
Abstrakt: Aim: To assess the occurrence and risk factors of gastrointestinal (GI) dysfunction during enteral nutrition (EN) in critically ill patients supported with mechanical ventilation.
Design: Prospective observational study.
Methods: Totally 252 patients admitted at a mixed medical-surgical ICU were enrolled. GI symptoms and the potential risk variables were recorded during the first 14 days of EN.
Results: The incidence of GI dysfunction was 65.5%, and the incidence of diarrhoea, constipation, abdominal distension, and upper GI intolerance was 28.2%, 18.3%, 6.7% and 12.3%, respectively. The median onset days of constipation, diarrhoea, abdominal distension and UDI was 3, 5, 5 and 6 days, respectively. Multivariable Cox regression analysis showed a significant relationship between GI dysfunction and age (HR = 2.321, 95% CI: 1.024-5.264, p = 0.004), APACHE-II score at ICU admission (HR = 7.523, 95% CI: 4.734-12.592, p = 0.018), serum albumin level (HR = 0.594, 95% CI: 0.218-0.889, p = 0.041), multidrug-resistant bacteria-positive culture (HR = 6.924, 95% CI: 4.612-10.276, p<0.001), negative fluid balance (HR = 0.725, 95% CI: 0.473-0.926, p = 0.037), use of vasopressor drugs (HR = 1.642, 95% CI: 1.297-3.178, p<0.001), EN way (HR = 6.312, 95% CI: 5.143-11.836, p<0.001), infusion rate (HR = 1.947, 95% CI: 1.135-3.339, p<0.001), and intra-abdominal hypertension (HR = 3.864, 95% CI: 2.360-5.839, p<0.001).
Conclusion: Critically ill patients supported with mechanical ventilation are at a high risk of GI dysfunction. Interventions such as the use of laxatives or prokinetic agents, control of EN infusion rate, and maintaining a normal state of hydration, might be beneficial for the prevention of GI dysfunction in critically ill patients.
Patient or Public Contribution: No.
(© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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