• Olga Kiss, Jekaterina Maizik, Kadri Tamme, Aivar Orav, van de Poll Marcel C G MCG Departments of Intensive Care Medicine and General Surgery, Maastricht University, Medical Center, School for Nutrition and Translational Resea, and Reintam Blaser Annika A Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia; Department of Intensive Care Medicine, Lucerne Cantonal Hos.
• Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia; Department of Anaesthesiology and Intensive Care, Tartu University Hospital, Tartu, Estonia.
• J Crit Care. 2020 Dec 1; 60: 120-126.

PurposeWe aimed to describe epidemiology of diarrhea and cholestasis in critically ill patients and explore associations between these two conditions.Material And MethodsWe performed a retrospective study including all consecutive patients who stayed in the ICU for at least 3 days and in whom plasma measurements of liver enzymes/cholestasis parameters were performed. Diarrhea was defined as 3 or more loose or liquid stools per day and cholestasis as increase of alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) 1.5 times above the upper limit of normality.ResultsDiarrhea was observed in 26.1% and cholestasis in 27.9% of study patients, about one third of the cases in both diarrhea and cholestasis occurred beyond the first week of patient's ICU stay. Cholestasis occurred in 45.6% of patients with diarrhea vs 28.0% of patients without diarrhea (p < 0.001). In 94 patients (13.1%) both diarrhea and cholestasis occurred, cholestasis was more commonly (2/3 of cases) documented before manifestation of diarrhea.ConclusionsCholestasis is more common in patients with diarrhea and vice versa. Diarrhea and cholestasis both occur in approximately one quarter of ICU patients, with significant proportion manifesting beyond the first week in the ICU.Copyright © 2020 Elsevier Inc. All rights reserved.

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