• Tessa Heinonen, Suzie Ferrie, and Clare Ferguson.
• Nutrition & Dietetics Program, School of Life and Environmental Sciences, University of Sydney NSW 2006, Australia. Electronic address: tessp4j@outlook.com.
• Aust Crit Care. 2020 Mar 1; 33 (2): 151-154.

BackgroundManagement of gut function in the intensive care unit (ICU) is often protocol-driven. Protocols for enteral feeding or bowel management are based on assumptions about what is 'normal' gastrointestinal motility during critical illness or in the early postoperative period, although 'normal' has not been well described in this group.ObjectivesThis study aimed to describe aspects of gut function based on an audit of current ICU patients.MethodsA retrospective medical audit of 100 recent consecutive ICU patients was conducted to obtain data on gut function parameters in the critically ill or postoperative population.ResultsThe audit indicated that delayed gastric emptying is common in the ICU. Regardless of the definition volume used, large gastric aspirates occurred in most enterally fed patients. Patient positioning was a significant influence, with a bed angle <30° associated with increased gastric aspirates (p = 0.0002). Constipation was more common among enterally fed patients than among orally fed ones (p = 0.001) and was associated with opioids (p = 0.009). Diarrhoea was associated with antibiotic use (p = 0.047). For enterally fed patients, the first bowel motion in the ICU occurred on average day 4.60 (standard deviation, 2.78), compared to day 2.72 (standard deviation, 1.67) for orally fed patients (p = 0.0001).ConclusionAlteration of upper and lower gastrointestinal motility is common in critically ill and early postoperative patients. Care should be taken in interpreting protocols that relate to gut function to avoid unnecessary interventions or interruptions to nutritional therapy.Copyright © 2019 Australian College of Critical Care Nurses Ltd. All rights reserved.

19 keywords...

hide…