Rectal tubes are frequently inserted and occasionally associated with major adverse events

Abstract

Introduction: There is an absence of epidemiological data on the frequency, indications and complications associated with the use of rectal tubes in the critically ill. Study objective: Our objective was to determine the frequency with which rectal tubes are placed and the rate of adverse events. Methods: We conducted a single centre observational study over 15 months. All patients admitted during this period had data contemporaneously entered using specific paper-based case report forms. We determined the frequency of insertion of rectal tubes in the ICU, as well as the rate of major and minor adverse events. Major events were defined as rectal tube insertions leading to adverse patient centred outcomes such as need for blood transfusion 2 units of packed red cells and endoscopy or operation. Results: Of 3421 index admissions, 101 patients (3.0%) had a rectal tube inserted with 641 patient insertion days. The majority of rectal tubes were placed because of diarrhoea or excessive bowel motions. Rectal tubes remained indwelling for 5 days (IQR 3 - 7). Three (2.9%) patients suffered a major adverse event (0.5 event per 100 days of rectal tube insertion) and 11 (10.8%) a minor adverse event (2.2 events per 100 days). Conclusions: At our ICU rectal tubes appear to be frequently inserted. Given major adverse events can occur with their placement greater governance surrounding their use may be appropriate.