J Crit Care: Do patients with intestinal nutrition support need preventive laxative intestinal management? No, you don't need to

Preventive laxative intestinal therapy can prevent constipation in critically ill patients receiving intestinal nutrition.
, however, the use of preventive drugs may also increase diarrhoea.
, it is not known whether such patients should be treated with preventive laxatives.
a systematic review published recently in J Crit Care showed that there were fewer trials of preventive laxative intestinal therapy for critically ill patients with frequent constipation and diarrhea, and that preventive drug therapy in such patients was not supported.
researchers searched articles in MEDLINE, Embase, and CINAHL that reported constipation or diarrhea and/or preventive laxative intestinal therapy in severe adult patients to explore the epidemiology of constipation and/or diarrhea in critically ill patients and to evaluate trials of preventive laxative intestinal therapy.
results showed that 20% to 83% of patients with severe illness had constipation and 3.3% to 78% of patients had diarrhea.
study identified six studies of preventive intestinal intestinal urination programmes, but only three randomized controlled trials.
meta-analysis of these studies showed that preventive diarrhea increased the risk of diarrhea (RR 1.58, 95% CI 1.22 to 2.04) compared to placebo, but did not reduce the risk of constipation (RR 0.39, 95% CI 0.14 to 1.05), nor did it affect the patient's mechanical airfly time, ICU hospitalization time, and mortality.
Results Forest Map: A Constipation and Diarrhea, B MV Duration, C into ICU Time, D Death Summary, The system review results show that constipation and diarrhea are common in critically ill patients receiving nutritional support, but there has been little research to evaluate preventive laxative intestinal therapy in such patients and does not support the use of preventive laxative intestinal therapy.