Jorge López1, Marta Botrán2, Ana García3, Rafael González4, María J Solana4, Javier Urbano4, Sarah N Fernández4, César Sánchez4, Jesús López-Herce4. 1. Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network of Carlos III Health Institute, Complutense University of Madrid, Madrid, Spain. Electronic address: dr_pyta@yahoo.es. 2. Pediatric Department, Nuevo Belén Madrid Hospital, Madrid, Spain. 3. Pediatric Department, Hospital Sur Alcorcón, Madrid, Spain. 4. Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Mother-Child Health and Development Network of Carlos III Health Institute, Complutense University of Madrid, Madrid, Spain.
Abstract
OBJECTIVE: To analyze the incidence and factors associated with constipation in critically ill children. STUDY DESIGN: We performed a prospective observational study that included children admitted to the pediatric intensive care unit for more than 3 days. Constipation was defined as more than 3 days without a bowel movement. Relationships between constipation and demographic data; clinical severity score; use of mechanical ventilation, use of vasoconstrictors, sedatives, and muscle relaxants; nutritional data; electrolyte disturbances; and clinical course were analyzed. RESULTS: Constipation developed in 46.7% of the 150 patients studied (mean age, 34.3 ± 7.1 months). It was most common in postoperative, older, and higher-body-weight patients, and in those with fecal continence (P < .01). Compared with patients without constipation, patients with constipation had higher severity scores and more frequently received midazolam, fentanyl, muscle relaxants, and inotropic support (P < .05). Patients with constipation also started nutrition later and with a lower volume of nutrition (P < .01). There were no between-group differences in mortality or length of pediatric intensive care unit stay. In multivariate analysis, independent factors associated with constipation were body weight (OR, 1.08; 95% CI, 1.03-1.13), Pediatric Index of Mortality 2 score (OR, 1.05; 95% CI, 1.02-1.09), admission after surgery (OR, 7.64; 95% CI, 2.56-22.81), and treatment with vasoconstrictors (OR, 10.28; 95% CI, 3.53-29.93). CONCLUSION: Constipation is common in critically ill children. Body weight, Pediatric Index of Mortality 2 clinical severity score, admission after surgery, and the need for vasoconstrictor therapy are major independent risk factors associated with constipation.
OBJECTIVE: To analyze the incidence and factors associated with constipation in critically ill children. STUDY DESIGN: We performed a prospective observational study that included children admitted to the pediatric intensive care unit for more than 3 days. Constipation was defined as more than 3 days without a bowel movement. Relationships between constipation and demographic data; clinical severity score; use of mechanical ventilation, use of vasoconstrictors, sedatives, and muscle relaxants; nutritional data; electrolyte disturbances; and clinical course were analyzed. RESULTS:Constipation developed in 46.7% of the 150 patients studied (mean age, 34.3 ± 7.1 months). It was most common in postoperative, older, and higher-body-weight patients, and in those with fecal continence (P < .01). Compared with patients without constipation, patients with constipation had higher severity scores and more frequently received midazolam, fentanyl, muscle relaxants, and inotropic support (P < .05). Patients with constipation also started nutrition later and with a lower volume of nutrition (P < .01). There were no between-group differences in mortality or length of pediatric intensive care unit stay. In multivariate analysis, independent factors associated with constipation were body weight (OR, 1.08; 95% CI, 1.03-1.13), Pediatric Index of Mortality 2 score (OR, 1.05; 95% CI, 1.02-1.09), admission after surgery (OR, 7.64; 95% CI, 2.56-22.81), and treatment with vasoconstrictors (OR, 10.28; 95% CI, 3.53-29.93). CONCLUSION:Constipation is common in critically ill children. Body weight, Pediatric Index of Mortality 2 clinical severity score, admission after surgery, and the need for vasoconstrictor therapy are major independent risk factors associated with constipation.
Authors: J López; C Sánchez; S N Fernández; R González; M J Solana; J Urbano; M Tolín; J López-Herce Journal: Biomed Res Int Date: 2017-01-26 Impact factor: 3.411
Authors: Gema Pérez; Elena González; Laura Zamora; Sarah N Fernández; Amelia Sánchez; Jose María Bellón; María José Santiago; María José Solana Journal: J Pediatr Gastroenterol Nutr Date: 2022-01-01 Impact factor: 3.288