Indications for and Complications of Rectal Tube Use in Critically Ill Patients

Abstract

To better define the indications for and complications of rectal tube use in critically ill patients we prospectively studied every patient admitted to an intensive care unit over a 20-month period who required a rectal tube. Of these patients, 2.8% had rectal tubes inserted. Ninety- two percent were inserted to help decrease soiling from diarrhea and 6% were inserted to deliver medica tions. Tubes were in place an average of 3.3 days, and no complications were identified. Rectal tubes may be safely and effectively used to prevent soiling in critically ill patients with diarrhea. The use of rectal tubes as ad juncts to healing and preventing pressure sores in criti cally ill patients merits further study.

GI Complications in Patients Receiving Mechanical Ventilation

“…127 Rectal tubes have been associated with complications including discomfort, local ulceration, infection, and perforation of rectum. 128 Prokinetic agents, such as erythromycin, have been shown to promote gastric emptying in patients receiving MV and should be considered once mechanical obstruction is excluded. Erythromycin, 200 mg once daily, can improve gastric motility in these patients by increasing the amplitude of antral contractions and improving antroduodenal coordination.…”