Chen Weiting, Wang Hehao, Chen Yingzi, Yuan Danqin, Chen Renhui
Department of Critical Care Medicine, Taizhou Hospital of Integrated Traditional Chinese and Western Medicine in Zhejiang, Wenlin, Zhejiang Province, China.
J Int Med Res. 2019 Oct;47(10):4929-4939. doi: 10.1177/0300060519868340. Epub 2019 Sep 11.
To investigate the prevalence of and factors associated with diarrhoea in the early stage of enteral nutrition in critically ill patients in intensive care units (ICUs).
This prospective, multicentre, observational study enrolled consecutive patients who were newly admitted to ICUs and received enteral nutrition treatment. Events were observed continuously for 7 days or until patients were transferred out of the ICU after enteral nutrition. Demographic and clinical data, enteral nutrition data, diarrhoea-related data and outcomes were recorded. A multivariate logistic regression analysis was used to analyse the risk factors for diarrhoea.
The study included 533 patients, of whom 164 (30.8%) developed diarrhoea. Diarrhoea was most commonly observed on the first to third days after starting enteral nutrition treatment. The median (interquartile range) duration of diarrhoea was 2 (1–3) days. The administration of gastrointestinal prokinetic agents, the increase in acute physiological and chronic health scores and the pyloric posterior feeding method were independent risk factors for diarrhoea.
The increased severity of illness, the administration of gastrointestinal prokinetic agents and the pyloric posterior feeding method were independent risk factors for diarrhoea in critically ill ICU patients undergoing enteral nutrition treatment.
调查重症监护病房（ICU）中危重症患者肠内营养早期腹泻的发生率及相关因素。
这项前瞻性、多中心、观察性研究纳入了连续入住ICU并接受肠内营养治疗的患者。连续观察7天或直至患者在肠内营养治疗后转出ICU。记录人口统计学和临床数据、肠内营养数据、腹泻相关数据及结局。采用多因素logistic回归分析腹泻的危险因素。
该研究纳入533例患者，其中164例（30.8%）发生腹泻。腹泻最常出现在开始肠内营养治疗后的第1至3天。腹泻的中位（四分位间距）持续时间为2（1 - 3）天。使用胃肠动力药、急性生理与慢性健康评分增加以及幽门后喂养方式是腹泻的独立危险因素。
病情严重程度增加、使用胃肠动力药以及幽门后喂养方式是接受肠内营养治疗的ICU危重症患者发生腹泻的独立危险因素。
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