Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs
Objective: The aim of this study was to evaluate the frequency of gastrointestinal alterations (GIA) and possible associated risk factors in critically ill patients with COVID-19 receiving enteral nutrition (EN) concomitantly with vasoactive drug (VAD) and/or neuromuscular blockers (NMB). Methods:...
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| Format: | Article |
| Language: | English |
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Editora Unijuí
2024-02-01
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| Series: | Revista Contexto & Saúde |
| Subjects: | |
| Online Access: | https://revistas.unijui.edu.br/index.php/contextoesaude/article/view/13615 |
| _version_ | 1797289150306582528 |
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| author | Jessica Sayume Makiyama da Silva Gabriela Lazzaron Slob Danielle Dantas Fernanda Furtado Jéssica Alves de Paula Larissa Farinha Maffini Luíza Silva Leite Sandra Regina Justino Estela Iraci Rabito |
| author_facet | Jessica Sayume Makiyama da Silva Gabriela Lazzaron Slob Danielle Dantas Fernanda Furtado Jéssica Alves de Paula Larissa Farinha Maffini Luíza Silva Leite Sandra Regina Justino Estela Iraci Rabito |
| author_sort | Jessica Sayume Makiyama da Silva |
| collection | DOAJ |
| description |
Objective: The aim of this study was to evaluate the frequency of gastrointestinal alterations (GIA) and possible associated risk factors in critically ill patients with COVID-19 receiving enteral nutrition (EN) concomitantly with vasoactive drug (VAD) and/or neuromuscular blockers (NMB). Methods: Retrospective cohort study, performed in intensive care units (ICU), with individuals over 18 years of age with COVID-19 who received concomitant exclusive EN with at least one VAD and/or one NMB in ≥ 1 day. GIA were: presence of ≥ 1 of the following changes: diarrhea (≥ 3 liquid stools/day), gastric residual volume (GRV), paralysis of the lower gastrointestinal tract (GIT) (absent evacuation for ≥ 3 consecutive days), emesis and gastrointestinal bleeding. A mixed logistic regression was used to assess the association of drugs with GIA and a multivariate logistic regression to assess potential confounders. Results: We evaluated 78 individuals and 774 days of hospitalization. All of them received EN within 48h and 70.5% died. The most frequent GIA were: lower GIT paralysis, 75 patients in 362 days; GRV, 18 patients at 34 days and diarrhea, 13 patients at 22 days. Norepinephrine was associated with GRV (p=0.003) and fentanyl (mcg/min) with the presence of GIA (p=0.029). Conclusions: The NMB showed no relationship with the assessed GIA, as for the VAD we suggest the assessment of norepinephrine as a possible risk factor for GRV.
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| first_indexed | 2024-03-07T18:59:52Z |
| format | Article |
| id | doaj.art-e7a3db92f57d4d408a4f2ddd5a74747c |
| institution | Directory Open Access Journal |
| issn | 2176-7114 |
| language | English |
| last_indexed | 2024-03-07T18:59:52Z |
| publishDate | 2024-02-01 |
| publisher | Editora Unijuí |
| record_format | Article |
| series | Revista Contexto & Saúde |
| spelling | doaj.art-e7a3db92f57d4d408a4f2ddd5a74747c2024-03-01T21:01:30ZengEditora UnijuíRevista Contexto & Saúde2176-71142024-02-01244810.21527/2176-7114.2024.48.13615Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugsJessica Sayume Makiyama da Silva0Gabriela Lazzaron Slob1Danielle Dantas2Fernanda Furtado3Jéssica Alves de Paula4Larissa Farinha Maffini5Luíza Silva Leite 6Sandra Regina Justino 7Estela Iraci Rabito8Universidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do ParanáUniversidade Federal do Paraná Objective: The aim of this study was to evaluate the frequency of gastrointestinal alterations (GIA) and possible associated risk factors in critically ill patients with COVID-19 receiving enteral nutrition (EN) concomitantly with vasoactive drug (VAD) and/or neuromuscular blockers (NMB). Methods: Retrospective cohort study, performed in intensive care units (ICU), with individuals over 18 years of age with COVID-19 who received concomitant exclusive EN with at least one VAD and/or one NMB in ≥ 1 day. GIA were: presence of ≥ 1 of the following changes: diarrhea (≥ 3 liquid stools/day), gastric residual volume (GRV), paralysis of the lower gastrointestinal tract (GIT) (absent evacuation for ≥ 3 consecutive days), emesis and gastrointestinal bleeding. A mixed logistic regression was used to assess the association of drugs with GIA and a multivariate logistic regression to assess potential confounders. Results: We evaluated 78 individuals and 774 days of hospitalization. All of them received EN within 48h and 70.5% died. The most frequent GIA were: lower GIT paralysis, 75 patients in 362 days; GRV, 18 patients at 34 days and diarrhea, 13 patients at 22 days. Norepinephrine was associated with GRV (p=0.003) and fentanyl (mcg/min) with the presence of GIA (p=0.029). Conclusions: The NMB showed no relationship with the assessed GIA, as for the VAD we suggest the assessment of norepinephrine as a possible risk factor for GRV. https://revistas.unijui.edu.br/index.php/contextoesaude/article/view/13615Enteral NutritionNeuromuscular Blocking AgentsVasoconstrictor AgentsCOVID-19Critical Care |
| spellingShingle | Jessica Sayume Makiyama da Silva Gabriela Lazzaron Slob Danielle Dantas Fernanda Furtado Jéssica Alves de Paula Larissa Farinha Maffini Luíza Silva Leite Sandra Regina Justino Estela Iraci Rabito Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs Revista Contexto & Saúde Enteral Nutrition Neuromuscular Blocking Agents Vasoconstrictor Agents COVID-19 Critical Care |
| title | Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs |
| title_full | Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs |
| title_fullStr | Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs |
| title_full_unstemmed | Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs |
| title_short | Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs |
| title_sort | gastrointestinal changes in critical patients with covid 19 receiving enteral nutritional neuromuscular blockers and or vasoactive drugs |
| topic | Enteral Nutrition Neuromuscular Blocking Agents Vasoconstrictor Agents COVID-19 Critical Care |
| url | https://revistas.unijui.edu.br/index.php/contextoesaude/article/view/13615 |
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