Gacouin et al identified a number of factors in mechanically-ventilated patients that may be associated with constipation. Delayed defecation may be associated with a number of complications for these patients. The authors are from Hopital Pontchaillou in Rennes, France.


Patient selection: ICU patient undergoing mechanical ventilation >= 6 days


Defecation was considered early if stool passed in < 6 days of ICU admission and delayed (associated with constipation) if stool passed >= 6 days after admission.


Risk factors for late defecation during the first 5 days in the ICU:

(1) PaO2 to FIO2 ratio < 150 mm Hg

(2) lowest recorded systolic blood pressure < 90 mm Hg


The odds ratios for these factors were in the 1.3 to 1.5 range.


Other considerations:

(1) medications

(2) reduced contents in the gastrointestinal tract


Complications assocaited with delayed constipation:

(1) a higher rate of acquired bacterial infections (66%)

(2) a higher mortality rate (30%)

(3) higher LOD (Logistic Organ Dysfunction) scores on days 4 to 9

(4) difficulty weaning


To read more or access our algorithms and calculators, please log in or register.