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

IF 2 4区 医学 Q2 NURSING Nursing Open Pub Date : 2024-11-01 DOI:10.1002/nop2.2247
Ling Shi, Jianmei Shao, Yuxia Luo, Guiyan Liu, Miao OuYang
{"title":"The incidence and risk factors of gastrointestinal dysfunction during enteral nutrition in mechanically ventilated critically ill patients.","authors":"Ling Shi, Jianmei Shao, Yuxia Luo, Guiyan Liu, Miao OuYang","doi":"10.1002/nop2.2247","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess the occurrence and risk factors of gastrointestinal (GI) dysfunction during enteral nutrition (EN) in critically ill patients supported with mechanical ventilation.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Patient or public contribution: </strong>No.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523002/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/nop2.2247","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0

Abstract

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.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
机械通气重症患者肠内营养期间胃肠功能紊乱的发生率和风险因素。
目的:评估机械通气支持下的重症患者肠内营养(EN)期间胃肠道(GI)功能障碍的发生率和风险因素:前瞻性观察研究:方法:共招募了 252 名内外科混合重症监护病房的住院患者。方法:共招募了 252 名内外科混合重症监护病房的住院患者,记录了他们在接受 EN 的前 14 天内出现的消化道症状和潜在的风险变量:结果:消化道功能障碍的发生率为 65.5%,腹泻、便秘、腹胀和上消化道不耐受的发生率分别为 28.2%、18.3%、6.7% 和 12.3%。便秘、腹泻、腹胀和上消化道不耐受的中位发病天数分别为 3 天、5 天、5 天和 6 天。多变量 Cox 回归分析显示,消化道功能障碍与年龄(HR = 2.321,95% CI:1.024-5.264,p = 0.004)、入院时的 APACHE-II 评分(HR = 7.523,95% CI:4.734-12.592,p = 0.018)、血清白蛋白水平(HR = 0.594,95% CI:0.218-0.889,p = 0.041)、多重耐药菌培养阳性(HR = 6.924,95% CI:4.612-10.276,pConclusion):使用机械通气的重症患者出现消化道功能障碍的风险很高。使用泻药或促动力药、控制 EN 输注速度、维持正常水合状态等干预措施可能有利于预防重症患者的消化道功能障碍:无。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Nursing Open
Nursing Open Nursing-General Nursing
CiteScore
3.60
自引率
4.30%
发文量
298
审稿时长
17 weeks
期刊介绍: Nursing Open is a peer reviewed open access journal that welcomes articles on all aspects of nursing and midwifery practice, research, education and policy. We aim to publish articles that contribute to the art and science of nursing and which have a positive impact on health either locally, nationally, regionally or globally
期刊最新文献
Assessing the Nursing Workload in the Cardiothoracic Intensive Care Unit: Comparative Study. Setting national nursing research priorities in Qatar: A Delphi survey. The incidence and risk factors of gastrointestinal dysfunction during enteral nutrition in mechanically ventilated critically ill patients. Psychological Distress in Patients With Recurrent Ectopic Pregnancies: A Cross-Sectional Study. Comfort Need of Hospitalised Patients With Covid-19 During Isolation Precaution: A Qualitative Study.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1