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Faecal diversion system usage in an adult intensive care unit
Objective: To determine the frequency, indications and complications associated with the use of faecal diversion systems (rectal tubes) in critically ill patients. Design: A single centre observational study over 15 months. Setting: Intensive care unit (ICU). Participants: Patients admitted during t...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692465/ https://www.ncbi.nlm.nih.gov/pubmed/32389107 http://dx.doi.org/10.51893/2020.2.oa5 |
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author | Wilson, Nicholas Bellomo, Rinaldo Hay, Tyler Fazio, Timothy Entwistle, Jasmine Presneill, Jeffrey J. Abdelhamid, Yasmine Ali Deane, Adam M. |
author_facet | Wilson, Nicholas Bellomo, Rinaldo Hay, Tyler Fazio, Timothy Entwistle, Jasmine Presneill, Jeffrey J. Abdelhamid, Yasmine Ali Deane, Adam M. |
author_sort | Wilson, Nicholas |
collection | PubMed |
description | Objective: To determine the frequency, indications and complications associated with the use of faecal diversion systems (rectal tubes) in critically ill patients. Design: A single centre observational study over 15 months. Setting: Intensive care unit (ICU). Participants: Patients admitted during this period. Main outcome measures: Frequency of rectal tubes utilisation in ICU, as well as associated adverse events, with major events defined as lower gastrointestinal bleeding associated with defined blood transfusion of two or more units of red cells or endoscopy or surgical intervention. Results: Of 3418 admission episodes, there were 111 episodes of rectal tubes inserted in 99 patients. Rectal tubes remained indwelling for a median of 5 days (range, 1–23) for a total of 641 patient-days. The most frequent indication for insertion was excessive bowel motions. A major adverse event was observed in three patients (3%; 0.5 events per 100 device days). Two patients underwent laparotomy and one patient sigmoidoscopy. These patients received between two and 23 units of packed red blood cells. Patients who had a rectal tube inserted had a substantially greater duration of ICU admission (mean, 14 days [SD, 14] v 2.8 days [SD, 3.7]) and hospital mortality (15% v 7.7%; risk ratio, 2.0; 95% CI, 1.2–3.4) as well as an overall higher Australian and New Zealand Risk of Death (ANZROD) score (mean, 27 [SD, 22] v 12.6 [SD, 20]). Conclusion: Rectal tubes appear to be frequently inserted and can lead to major adverse events in critically ill patients. |
format | Online Article Text |
id | pubmed-10692465 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-106924652023-12-03 Faecal diversion system usage in an adult intensive care unit Wilson, Nicholas Bellomo, Rinaldo Hay, Tyler Fazio, Timothy Entwistle, Jasmine Presneill, Jeffrey J. Abdelhamid, Yasmine Ali Deane, Adam M. Crit Care Resusc Original Articles Objective: To determine the frequency, indications and complications associated with the use of faecal diversion systems (rectal tubes) in critically ill patients. Design: A single centre observational study over 15 months. Setting: Intensive care unit (ICU). Participants: Patients admitted during this period. Main outcome measures: Frequency of rectal tubes utilisation in ICU, as well as associated adverse events, with major events defined as lower gastrointestinal bleeding associated with defined blood transfusion of two or more units of red cells or endoscopy or surgical intervention. Results: Of 3418 admission episodes, there were 111 episodes of rectal tubes inserted in 99 patients. Rectal tubes remained indwelling for a median of 5 days (range, 1–23) for a total of 641 patient-days. The most frequent indication for insertion was excessive bowel motions. A major adverse event was observed in three patients (3%; 0.5 events per 100 device days). Two patients underwent laparotomy and one patient sigmoidoscopy. These patients received between two and 23 units of packed red blood cells. Patients who had a rectal tube inserted had a substantially greater duration of ICU admission (mean, 14 days [SD, 14] v 2.8 days [SD, 3.7]) and hospital mortality (15% v 7.7%; risk ratio, 2.0; 95% CI, 1.2–3.4) as well as an overall higher Australian and New Zealand Risk of Death (ANZROD) score (mean, 27 [SD, 22] v 12.6 [SD, 20]). Conclusion: Rectal tubes appear to be frequently inserted and can lead to major adverse events in critically ill patients. Elsevier 2023-10-18 /pmc/articles/PMC10692465/ /pubmed/32389107 http://dx.doi.org/10.51893/2020.2.oa5 Text en © 2020 College of Intensive Care Medicine of Australia and New Zealand. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Articles Wilson, Nicholas Bellomo, Rinaldo Hay, Tyler Fazio, Timothy Entwistle, Jasmine Presneill, Jeffrey J. Abdelhamid, Yasmine Ali Deane, Adam M. Faecal diversion system usage in an adult intensive care unit |
title | Faecal diversion system usage in an adult intensive care unit |
title_full | Faecal diversion system usage in an adult intensive care unit |
title_fullStr | Faecal diversion system usage in an adult intensive care unit |
title_full_unstemmed | Faecal diversion system usage in an adult intensive care unit |
title_short | Faecal diversion system usage in an adult intensive care unit |
title_sort | faecal diversion system usage in an adult intensive care unit |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692465/ https://www.ncbi.nlm.nih.gov/pubmed/32389107 http://dx.doi.org/10.51893/2020.2.oa5 |
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