Use of Prokinetic Agents in Adult ICU Patients: An International Inception Cohort Study (PATIENCE).

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Acta Anaesthesiologica Scandinavica Pub Date : 2026-08-01 DOI:10.1111/aas.70290

Vera Crone, Morten Hylander Møller, Anders Granholm, Anders Perner, Waleed Alhazzani, Laura Rindom Krogsgaard, Abdulrahman Al-Fares, Johanna Hästbacka, Marlies Ostermann, Carmen A Pfortmueller, Ricard Ferrer, Annika Reintam Blaser, Olof Wall, Eric Keus, Wojciech Szczeklik, Peter Martin Hansen, Jens Michelsen, Mikkel Bak, Lise Skyttegaard Balkert, Tino Severinsen, Anne Craveiro Brøchner, Jonas Elmer Pedersen, Anne Sofie Andreasen, Camilla Tageby Nielsen, Theis Skovsgaard Itenov, Maj-Brit Nørregaard Kjær, Zemira Engbakken, Morten Heiberg Bestle, Peter Buhl Hjortrup, Christian Juhl Svendsen, Sandra Lindkvist-Viggers, Björn Anders Brand, Andreas Bender Jonsson, Tobias Browall Krogh, Kristian Reinhold Jauho, Mathias Sinkbæk Thomsen, Therese Simonsen Straarup, Eva Poulsen, Christian Gade Nissen, Olena Breum, Per Lund Petersen, Christopher Torp, Bodil Steen Rasmussen, Anne-Marie Gellert Bunzel, Seraina-Flavia Buholzer, Elizabeth Hardman, Daniel Törnberg, David S Pérez, Kenneth van Smaalen, Marisa Onrust, Liivi Maddison, Oskar Appelberg, Hans-Erik Ehrlich, Kadri Tamme, Reile Juhanson, Jaanus Korjas, Ville Jalkanen, Marleena Finni, Matti Reinikainen, Talvikki Koskue, Marcelina Czok, Pawel Zatorski, Oliwia Doroba, Bartosz Kudlinski, Pawel Nowak, Szymon Bialka, Anna Kluzik, Hanna Baran, Zainab Al Duhailib, Hakeam A Hakeam, Mohammed Alshahrani, Osama Ahmed Elfaki, Fadah A Alanazi, Rakan Aldhahri, Khairallah Belkhouja, Ali Alahmari, Rawabi M Alsayer, Ola Friman, Anca Balintescu, Mette Krag

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引用次数: 0

Abstract

Background: Feeding intolerance is common in intensive care unit (ICU) patients, but evidence supporting prokinetic use is limited. We aimed to provide international epidemiological data on the use of prokinetic agents in adult ICU patients and to explore potential associations with patient-important outcomes.

Methods: We conducted an inception cohort study between August 2024 and March 2025 in acutely admitted ICU patients in 56 ICUs across 11 countries. The primary outcome was the proportion of patients receiving prokinetic agents. Secondary outcomes included associations with baseline characteristics, serious adverse events (SAEs), days alive out of ICU/hospital, days alive without life support and 90-day mortality. Associations with SAEs, baseline characteristics and mortality were assessed using pre-specified Cox regression models, while other secondary outcomes were evaluated using adjusted linear regression. All models were adjusted for country, severity of illness, number of comorbidities, surgery and ICU admission type.

Results: Among 1440 ICU patients (median age 64 years, 56.9% male), 187 (13.0%; 95% confidence interval [CI] 11.3-14.8) received prokinetic agents during ICU stay, most commonly metoclopramide (65%). Prior abdominal surgery was associated with the initiation of prokinetic agents (hazard ratio [HR] 1.81; 95% CI 1.17-2.79). Use of prokinetic agents was statistically significantly associated with a higher hazard of experiencing a SAE (HR 1.9; 95% CI 1.3-2.8), fewer days alive out of ICU (mean difference [MD] -7.6 days; 95% CI, -13.4 to -2.2) and hospital (-13.5 days; 95% CI -18.7 to -8.4), but not with 90-day mortality (HR 0.62; 95% CI 0.3-1.2).

Conclusions: Prokinetic agents were used in 13% of ICU patients, most commonly metoclopramide and more often in those with prior abdominal surgery. Prokinetic use was associated with a higher hazard of experiencing SAEs and fewer days alive out of hospital/ICU.

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成人ICU患者使用促动力学药物：一项国际初始队列研究（PATIENCE）。

背景：喂养不耐受在重症监护病房（ICU）患者中很常见，但支持促动力使用的证据有限。我们的目的是提供促动力学药物在成人ICU患者中使用的国际流行病学数据，并探讨其与患者重要结局的潜在关联。方法：我们在2024年8月至2025年3月期间对11个国家56个ICU的急性ICU患者进行了一项初始队列研究。主要结局是接受促动力药物治疗的患者比例。次要结局包括与基线特征、严重不良事件（sae）、离开ICU/医院的存活天数、无生命支持的存活天数和90天死亡率的关联。使用预先指定的Cox回归模型评估与sae、基线特征和死亡率的关联，而其他次要结局使用调整后的线性回归评估。所有模型都根据国家、疾病严重程度、合并症数量、手术和ICU入院类型进行了调整。结果：1440例ICU患者（中位年龄64岁，男性56.9%）中，187例（13.0%；95%可信区间[CI] 11.3 ~ 14.8）在ICU住院期间使用促动力学药物，最常见的是甲氧氯普胺（65%）。既往腹部手术与开始使用促动力药物相关（风险比[HR] 1.81; 95% CI 1.17-2.79）。使用促动力学药物与发生SAE的较高风险（HR 1.9; 95% CI 1.3-2.8）、离开ICU存活天数减少（平均差[MD] -7.6天；95% CI -13.4至-2.2）和住院天数减少（-13.5天；95% CI -18.7至-8.4）相关，但与90天死亡率无关（HR 0.62; 95% CI 0.3-1.2）。结论：13%的ICU患者使用促动力学药物，最常见的是甲氧氯普胺，既往腹部手术的患者更常见。主动使用与发生SAEs的风险较高和离开医院/ICU的存活天数较短相关。

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

Acta Anaesthesiologica Scandinavica 医学-麻醉学

CiteScore

4.30

自引率

9.50%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.