New protocol helps prevent constipation in critically ill patients

Constipated patients are more likely to fail to wean from mechanical ventilation than non constipated patients according to research conducted at the Royal Liverpool and Broadgreen University Hospital Trust.

In a poster presentation at the RCN International Research Conference in Liverpool, Gillian Ritchie, senior nurse research and development at the Royal Liverpool and Broadgreen Trust, reported that that a 2003 study found that that 83% of ventilated patients in ICU for more than three days were constipated. Over 40% of these patients failed to wean from mechanical ventilation (Mostafa et al 2003).

A protocol for the prevention of constipation was developed and an evaluation involving 42 patients found that 40% were constipated after its introduction compared with 83% identified in the earlier study. 24% of constipated patients failed to wean from controlled ventilation compared with 12% of non constipated patients.

Miss Ritchie concluded that the protocol reduced the incidence of constipation in ICU and that further research is required into the link between constipation and failure to wean from ventilation.

Reference: Mostafa SM et al (2003) Constipation and its implications in the critically ill patient. British Journal of Anaesthesia 91:815-9