Atasever AG, et al. - Experts undertook an inquiry of the frequency, risk factors and complications of gastrointestinal (GI) dysfunction during enteral nutrition (EN) in the first 2 weeks of the Intensive Care Unit (ICU) stay. Furthermore, they aspired to determine the precautions for preventing the development of GI dysfunction and avoid complications. Data suggested that GI dysfunction ought to be regarded as a clinical predictor of inadequate nutrition and prolonged length of stay (LOS). Individuals with multidrug-resistant (MDR) bacteria growth in the culture and patients in negative fluid balance exhibited the most dramatic risk for GI dysfunction. Appropriate nutrition for patients, along with prompt intervention and the development of treatment strategies were offered by intensivists in the event of GI dysfunction.

Methods

• The scheme of this research was a prospective observational study.
• The at-risk patients were analyzed.
• Eligible candidates included 137 patients who received nasogastric tube feeding in an ICU of a tertiary hospital.

Results

• Findings revealed that the incidence of GI dysfunction was 63%.
• It was associated primarily between MDR bacteria positivity and negative fluid balance.
• A total of 36 patients (26%) presented with diarrhea, on 147 patient-days (incidence rate, 5.5 per 100 patient-days).
• As per the outcomes, the median day of diarrhea onset was 6 days after the initiation of EN.
• Constipation was noted in 40 subjects (29%) presented with constipation (85% during the first week).
• Upper digestive intolerance was reported in 50 patients (36%) on 212 patient-days (incidence rate, 7.9 per 100 patient-days), after a median EN duration of 6 days (range, 2-14 days).
• MDR bacteria growth was found in the culture (OR, 1.75; 95% CI, 1.15-2.67; P=0.008) and negative fluid balance (OR, 0.57; 95% CI, 0.34-0.94; P=0.03) served as the risk factors for GI dysfunction, as per the Logistic regression analysis.
• A link was unveiled between GI dysfunction with high SOFA score, hypo-albuminemia, catecholamine use, and prolonged length of stay (LOS).
• It was also determined that GI dysfunction could lead to certain complications, such as inadequate nutrition and newly developed decubitus ulcers.