Constipation in a cohort prospective in adult critically ill patients: How much occurs and why?

Abstract

ObjectiveTo assess the incidence and factors associated with constipation in adult critical care patients. DesignProspective cohort study. Settingintensive care unit (ICU) of a high-complexity hospital from November 2015 to October 2016. Patientsadults who were hospitalized for at least 72h in the ICU were followed from their admission to the ICU until their departure. InterventionsNone. Measurements and main resultsIn 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. ConclusionConstipation 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.