The frequency, risk factors, and complications of gastrointestinal dysfunction during enteral nutrition in critically ill patients

Figures & data

Figure 1 Flowchart of the study cohort.

Abbreviations: ICU, intensive care unit; GI, gastrointestinal; LOS, length of stay.

Table 1 Diagnostic categories for Group I (with GI dysfunction) and Group II (without GI dysfunction)

Diagnosis	Group I (n=86 [63%])	Group II (n=51 [37%])
Medical/surgical	70 (81%)/16 (19%)	37 (72%)/14 (28%)
Cardiac	46	20
DM	34	16
Respiratory	28	11
Neurological	18	16
Renal failure	16	9
Hematologic	14	8

Abbreviations: GI, gastrointestinal; DM, diabetes mellitus.

Table 2 Comparison of the two groups according to the patient characteristics at admission

	Group I n=86	Group II n=51	P-value
Age, years	62±18	60±20	0.7
BMI, kg/m^2	27±4.7	27±6.4	0.7
SOFA	7.1±3.7	5.9±3.7	0.04
APACHE II	21±7.4	21±9.9	0.8

Note: Group 1: Patients with GI dysfunction; Group 2: Patients without GI dysfunction.

Abbreviations: GI, gastrointestinal; BMI, body mass index; SOFA, sequential organ failure assessment; APACHE II, acute physiology and chronic health evaluation II.

Table 3 Epidemiology of GI dysfunction during the first 14 days of the ICU stay (number of days [per 100 patient-days])

Number of days without GI dysfunction	1,132 (42)
Diarrhea incidence	147 (5.5)
UDI incidence	212 (7.9)
Constipation incidence	188 (7.0)
Vomiting incidence	82 (3.0)

Abbreviations: GI, gastrointestinal; ICU, intensive care unit; UDI, upper digestive intolerance.

Table 4 Multivariate analysis of risk factors for GI dysfunction during EN in 137 patients in the ICU

Variable	Wald	P-value	OR	95% CI
MDR bacteria-positive culture	6.97	0.008	1.75	1.15–2.67
Negative fluid balance	4.71	0.03	0.57	0.34–0.94

Abbreviations: GI, gastrointestinal; EN, enteral nutrition; ICU, intensive care unit; OR, odds ratio; CI, confidence interval; MDR, multidrug resistant.

Table 5 Treatments during EN in 137 patients in the ICU (n [%])

Treatments	Group I n=86	Group II n=51	P-value
Catecholamines use	50 (58%)	21 (41%)	<0.001
Sedative drugs	67 (78%)	37 (72.5%)	0.47
Insulin	42 (48%)	20 (39%)	0.27
Antifungal drugs	31 (36%)	13 (25%)	0.14

Note: Group 1: Patients with GI dysfunction; Group 2: Patients without GI dysfunction.

Abbreviations: EN, enteral nutrition; ICU, intensive care unit; GI, gastrointestinal.

Table 6 Comparison of outcome according to measurement of GI dysfunction during EN in 137 patients in the ICU (n [%])

Outcomes	Group I n=86	Group II n=51	P-value
Pneumonia	28 (32.6%)	11 (21.6%)	0.16
Mortality	43 (50%)	18 (35%)	0.094
Unable to reach target energy intake	23 (25%)	2 (4.4%)	0.003
Decubitus ulcers	45 (52%)	15 (29%)	0.009
LOS	21.4±17	16±18.5	0.002

Note: Group 1: Patients with GI dysfunction; Group 2: Patients without GI dysfunction.

Abbreviations: GI, gastrointestinal; EN, enteral nutrition; ICU, intensive care unit; LOS, length of stay.