Gastrointestinal changes in critical patients with covid-19 receiving enteral nutritional, neuromuscular blockers and/or vasoactive drugs
DOI:
https://doi.org/10.21527/2176-7114.2024.48.13615Keywords:
Enteral Nutrition, Neuromuscular Blocking Agents, Vasoconstrictor Agents, COVID-19, Critical CareAbstract
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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