Constipation in long-term ventilated patients: Associated factors and impact on intensive care unit outcomes*

Abstract

A Pao2/Fio2 ratio of < 150 mm Hg and systolic blood pressure of < 90 mm Hg during the first 5 days of mechanical ventilation were independently associated with a delay in defecation. Our results suggest that constipation is associated with adverse outcomes in long-term ventilated patients.

Frequency of Disturbed Defecation Pattern in Neurosurgical Critically Ill Patients and Influence on Intracranial Pressure and Intensive Care Treatment

“…Correspondingly norepinephrine that was used as first line vasopressor also had to be given in higher dosage when defecation pattern was inadequate. These findings are in concordance to literature where an association between sedatives, analgesics (especially opioids) and vasopressors and constipation is described [5,7,[24][25][26]. All these drugs are well-known to impair gut motility in a dose-dependent manner.…”

“…This can result in an increase in intra-abdominal pressure (IAP) and potentially an increased intracranial pressure (ICP) [1][2][3]. In addition, an insufficient defecation rate is possibly associated with prolonged ventilation, increased rate of bacterial infection and a higher mortality rate [4][5][6][7][8][9][10].…”

Constipation Occurrence among Critically Ill patients

“…They found a higher constipation rate among the mechanically ventilated patients. As above Gacouin et al (27) and Spodniewska et al (12) observed that the mechanical ventilation duration is higher in constipated patients…”

Perbandingan Abdominal Massage dengan Teknik Swedish Massage dan Teknik Effleurage terhadap Kejadian Konstipasi pada Pasien yang Terpasang Ventilasi Mekanik di ICU

“…Kriteria yang digunakan untuk mendefinisikan konstipasi pada pasien kritis di ICU adalah apabila tidak ada defekasi sedikitnya dalam 3-4 hari perawatan di ICU (Azedo & Machado, 2013;Gacoin et al, 2010;Mustofa, Bhandari, Ritchie, Gratton & Wenstone, 2003). Kejadian konstipasi paling sering terjadi pada pasien yang terpasang ventilasi mekanik.…”

“…Penurunan motilitas gastrointestinal terjadi karena kondisi hipoksemia, hipotensi, penggunaan ventilasi mekanik dengan positive end expiratory pressure (PEEP) dan efek samping sedasi analgetik dan vasopresor. Penelitian Gacoin et al (2010) menunjukkan bahwa kondisi pasien dengan PaO 2 / FiO 2 rasio < 150 mmHg dan sistolic blood pressure (SBP) < 90 mmHg selama 4 hari pemasangan ventilasi mekanik beresiko tinggi mengakibatkan konstipasi.…”