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
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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.

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。
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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
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