Diarrhoea risk factors in critically ill patients receiving enteral nutrition

• Main Authors: Kamarul Zaman, Mazuin, Raja Noor Azman, Raja Syakilla, Tah, Pei Chien, Hasan, Mohd Shahnaz
• Format: Article
• Published: Universiti Putra Malaysia Press 2021
• Subjects: R Medicine
• Online Access: http://eprints.um.edu.my/35561/
• Institution: Universiti Malaya

Introduction: Diarrhoea affects up to 95 of critically ill patients receiving enteral nutrition (EN). EN is commonly misjudged as the factor causing diarrhoea. This study aimed to investigate factors contributing to diarrhoea among critically ill patients receiving EN. Methods: A prospective observational study was conducted in general intensive care unit (ICU) of a teaching hospital. Newly admitted critically ill adult patients receiving exclusive enteral nutrition were included in this study. Data were collected up to 14 days or until discharge, whichever comes earlier. Faecal output was measured using King’s Stool Chart. Multivariate logistic regression was employed to identify aetiologies of diarrhoea during EN. Results:A total of 102 patients were analysed. Diarrhoea incidence was 48. Daily faecal score was higher 10.2 (7) among critically ill patients with diarrhoea compared to non-diarrhoea patients 2.9 (15), p<0.001. Median diarrhoea onset day was at day four post-admission. Length of ICU stay and use of diuretic were factors contributing to occurrence of diarrhoea during EN (odds ratio OR 0.173, 95% confidence interval CI 1.05-1.336, p=0.004 and OR 2.381, CI 2.092 -5.927, p=0.004). Conclusion: Diarrhoea is common among critically ill patients receiving EN. Diarrhoea during critical illness was not attributed to enteral nutrition. Length of stay and use of diuretics were factors contributing to diarrhoea in critically ill patients receiving EN. These findings may assist for continuity and abstinence from unnecessary cessation of feeding when critically ill patients develop diarrhoea. © 2021 UPM Press. All rights reserved.