纳洛美丁与阿片类药物诱导便秘的危重症患者更早排便相关：一项回顾性、单中心队列研究。
Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study.
机构信息
Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Saitama Medical Center, Omiya, Saitama, Japan.
Data Science Center, Jichi Medical University, Shimotsuke, Tochigi, Japan.
出版信息
PLoS One. 2024 Jan 3;19(1):e0295952. doi: 10.1371/journal.pone.0295952. eCollection 2024.
INTRODUCTION
There are few reports describing the association of naldemedine with defecation in critically ill patients with opioid-induced constipation. The purpose of this study was to determine whether naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.
METHODS
In this retrospective cohort study, patients admitted to the Intensive Care Unit (ICU) without defecation for 48 hours while receiving opioids were eligible for enrollment. The primary endpoint was the time of the first defecation within 96 hours after inclusion. Secondary endpoints included presence of diarrhea, duration of mechanical ventilation, ICU length of stay, ICU mortality, and in-hospital mortality. The Cox proportional hazard regression analysis with time-dependent covariates was used to evaluate the association naldemedine with earlier defecation.
RESULTS
A total of 875 patients were enrolled and were divided into 63 patients treated with naldemedine and 812 patients not treated. Defecation was observed in 58.7% of the naldemedine group and 48.8% of the no-naldemedine group during the study (p = 0.150). The naldemedine group had statistically significantly prolonged duration of mechanical ventilation (8.7 days vs 5.5 days, p < 0.001) and ICU length of stay (11.8 days vs 9.2 days, p = 0.001) compared to the no-naldemedine group. However, the administration of naldemedine was significantly associated with earlier defecation [hazard ratio:2.53; 95% confidence interval: 1.71-3.75, p < 0.001].
CONCLUSION
The present study shows that naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.
介绍
很少有报告描述纳洛美丁与阿片类药物引起的便秘的危重患者排便之间的关系。本研究的目的是确定纳洛美丁是否与阿片类药物引起的便秘的危重患者更早排便有关。
方法
在这项回顾性队列研究中，入住重症监护病房（ICU）且在接受阿片类药物治疗 48 小时内未排便的患者符合入组条件。主要终点是纳入后 96 小时内首次排便的时间。次要终点包括腹泻的存在、机械通气的持续时间、ICU 住院时间、ICU 死亡率和院内死亡率。使用带有时间依赖性协变量的 Cox 比例风险回归分析来评估纳洛美丁与更早排便的关系。
结果
共纳入 875 例患者，分为 63 例纳洛美丁治疗组和 812 例未治疗组。研究期间，纳洛美丁组有 58.7%的患者排便，而未纳洛美丁组有 48.8%的患者排便（p = 0.150）。与未纳洛美丁组相比，纳洛美丁组机械通气持续时间（8.7 天比 5.5 天，p < 0.001）和 ICU 住院时间（11.8 天比 9.2 天，p = 0.001）明显延长。然而，纳洛美丁的给药与更早的排便明显相关[风险比：2.53；95%置信区间：1.71-3.75，p < 0.001]。
结论
本研究表明，纳洛美丁与阿片类药物引起的便秘的危重患者更早排便有关。
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