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Constipation in a cohort prospective in adult critically ill patients: How much occurs and why?
Estreñimiento en una cohorte prospectiva de adultos críticos: porcentaje y motivo de su incidencia
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É. Batassinia,b,1,
Corresponding author
ericabatassini@hotmail.com

Corresponding author.
, M.G. Beghettoa,1
a Postgraduate Program in Nursing, Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
b Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
This item has received
Received 08 March 2018. Accepted 21 May 2018
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Table 1. Characteristics of the total sample of patients and treatments attributed to patients with and without constipation.
Table 2. Crude and adjusted hazard ratio for constipation.
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Abstract
Objective

To assess the incidence and factors associated with constipation in adult critical care patients.

Design

Prospective cohort study.

Setting

intensive care unit (ICU) of a high-complexity hospital from November 2015 to October 2016.

Patients

adults who were hospitalized for at least 72h in the ICU were followed from their admission to the ICU until their departure.

Interventions

None.

Measurements and main results

In the 157 patients followed up, the incidence of constipation was 75.8%. The univariate analysis showed that constipated patients were younger, used more sedation and showed more respiratory and postoperative causes for hospitalization, while non-constipated patients were hospitalized more for gastrointestinal reasons. The use of vasoactive substances, mechanical ventilation and haemodialysis was similar between the constipated and non-constipated patients. Multivariate analysis, days of use of docusate+bisacodyl (HR: .79; 95% CI: .65–.96) of omeprazole or ranitidine (HR: .80; 95%CI: .73–.88) and lactulose (HR: .87; 95%CI: .76–.99) were independent protection factors for constipation.

Conclusion

Constipation has a high incidence among adult critical care patients. Days of drug use acting on the digestive tract (lactulose, docusate+bisacodyl and omeprazole and/or ranitidine) are able to prevent this outcome.

Keywords:
Constipation
Critical care
Intensive care nursing
Resumen
Objetivo

Valorar la incidencia y factores de riesgo asociados al estreñimiento en pacientes adultos, en estado crítico.

Diseño

Estudio prospectivo de cohortes.

Ámbito

Unidad de cuidados intensivos (UCI) de un hospital de alta complejidad de noviembre de 2015 a octubre de 2016.

Sujetos

Se realizó un seguimiento a los adultos que fueron hospitalizados durante al menos 72h en la UCI, desde su ingreso en dicha unidad hasta su salida.

Intervenciones

Ninguna.

Mediciones y resultados principales

En los 157 pacientes seguidos, la incidencia de estreñimiento fue del 75,8%. El análisis univariado mostró que los pacientes con estreñimiento eran más jóvenes, habían usado más sedación y habían tenido más problemas respiratorios y posoperatorios como causas de hospitalización. Los pacientes sin estreñimiento habían sido hospitalizados más veces debido a motivos gastrointestinales. El uso de fármacos vasoactivos, la ventilación mecánica y la hemodiálisis fue similar entre los pacientes con estreñimiento y aquellos sin estreñimiento. El análisis multivariado, los días de administración de docusato+bisacodilo (HR0,79; IC95%: 0,65–0,96), de omeprazol o ranitidina (HR: 0,80; IC95%: 0,73–0,88) y de lactulosa (HR: 0,87; IC95%: 0,76–0,99) fueron factores independientes de protección para el estreñimiento.

Conclusión

El estreñimiento es muy incidente en los adultos críticos. Los días de administración de fármacos que actúan sobre el tracto digestivo (Lactulosa, docusato+bisacodil y omeprazol y/o ranitidina) son capaces de prevenir este desenlace.

Palabras clave:
Estreñimiento
Cuidados críticos
Cuidados intensivos enfermería

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