Backgrounds and aims Constipation in critically ill patients is associated with severity of illness. There are no clinical guidelines in critically ill children. The aim of this study is to review the results with our treatment protocol.
Methods Prospective observational study including children admitted to the PICU >3 days. Constipation was defined as ≥4 days with no stools. Constipation was treated with saline rectal enemas or polyethylene glycol + ions (PEGI). PEGI was prepared mixing one paediatric packet (6.9 g) with 20 ml of water. Initial dose was 1–2 ml/kg/8 h and after intestinal transit was observed, it was diminished to 0,5–1 ml/kg/24 h. Adult preparation form (13,8 g) in 40 ml of water was used in children >25 kg. Clinical and demographic data were recorded.
Results 68/150 patients (45.3%), median age 38.5 months (IQR 8.5–82.5) had constipation. Rectal enemas were administered to 15 patients (19.2%). It was useful (stool produced within the next two hours) in 50% of them. 47 patients (60.2%) were treated with PEGI obtaining stool production in the next 48 h in 60.3% of them. Median (IQR) dose of PGEI was 0.9 (0.6–1.3 g/kg/day). Median (IQR) time to first stool production after PEGI was 1 (0–2 days). Diarrhoea was the most frequent side effect observed in 4 patients with PEGI.
Conclusions Constipation in critically ill children is a very common problem. Our treatment protocol seems to be useful and secure. More studies are necessary to evaluate treatment efficacy and security and to develop clinical guidelines.
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