LB087
EARLY GASTROINTESTINAL DYSMOTILITY TRAJECTORY DURING THE FIRST FIVE ICU DAYS AND ENTERAL NUTRITION EXPOSURE IN MECHANICALLY VENTILATED CRITICALLY ILL ONCOLOGY PATIENTS: A PROSPECTIVE OBSERVATIONAL COHORT
I. Medeiros1,2,*, N. Machado1, G. A. Ozório3, J. M. Silva Júnior4
1Anestesiologia, Faculdade de Medicina USP, 2Terapia Intensiva, Instituto do Câncer do Estado de São Paulo (ICESP), 3Nutrição, Instituto do Cancer do Estado de Sao Paulo, São Paulo, 4Cirurgia e Anatomia, Faculdade de Medicina USP Ribeirão Preto, Ribeirão Preto, Brazil
Rationale: Gastrointestinal dysfunction is increasingly recognized in critically ill patients and may impair the implementation of enteral nutrition, particularly in mechanically ventilated oncology patients.
Methods: We conducted a prospective observational cohort including adult oncology patients admitted to the ICU and requiring mechanical ventilation. Daily gastrointestinal assessments were analyzed from ICU admission to day 5. Gastrointestinal dysmotility was defined as the presence of at least one of the following: absence of bowel movements in the previous 24 hours, diarrhea, or gastrointestinal complication
Results: Among 161 registered patients, 45 had at least three gastrointestinal assessments within the first five ICU days and were included in this analysis. Gastrointestinal dysmotility was highly prevalent and fluctuated over time, affecting 82.2% of patients at ICU admission, 64.7% on day 1, 57.1% on day 2, 54.8% on day 3, 73.9% on day 4, and 72.2% on day 5. Hypomotility/absence of bowel movements was the predominant phenotype across all time points. Persistent dysmotility occurred in 28/45 patients (62.2%). Enteral nutrition exposure was present in 57.8% at admission, increased to 73.2% on day 3, and was 55.6% on day 5. In complete longitudinal cases with all six assessments available (n=19), persistent dysmotility was observed in 84.2%, despite enteral nutrition exposure in 63.2–89.5% across the first five ICU days.
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Conclusion: Early gastrointestinal dysmotility was frequent and heterogeneous during the first five ICU days in mechanically ventilated oncology patients. Although enteral nutrition was commonly initiated, gastrointestinal dysfunction remained highly prevalent, supporting the need for structured daily gastrointestinal monitoring to guide nutritional therapy in oncology ICU patients.
Disclosure of Interest: None declared