Use of Prokinetic Agents in Adult ICU Patients: An International Inception Cohort Study (PATIENCE)
Crone, Vera; Møller, Morten Hylander; Granholm, Anders; Perner, Anders; Alhazzani, Waleed; Krogsgaard, Laura Rindom; Al-Fares, Abdulrahman; Hästbacka, Johanna; Ostermann, Marlies; Pfortmueller, Carmen A.; Ferrer, Ricard; Blaser, Annika Reintam; Wall, Olof; Keus, Eric; Szczeklik, Wojciech; Hansen, Peter Martin; Michelsen, Jens; Bak, Mikkel; Balkert, Lise Skyttegaard; Severinsen, Tino; Brøchner, Anne Craveiro; Pedersen, Jonas Elmer; Andreasen, Anne Sofie; Nielsen, Camilla Tageby; Itenov, Theis Skovsgaard; Kjær, Maj Brit Nørregaard; Engbakken, Zemira; Bestle, Morten Heiberg; Hjortrup, Peter Buhl; Svendsen, Christian Juhl; Lindkvist-Viggers, Sandra; Brand, Björn Anders; Jonsson, Andreas Bender; Krogh, Tobias Browall; Jauho, Kristian Reinhold; Thomsen, Mathias Sinkbæk; Straarup, Therese Simonsen; Poulsen, Eva; Nissen, Christian Gade; Breum, Olena; Petersen, Per Lund; Torp, Christopher; Rasmussen, Bodil Steen; Bunzel, Anne Marie Gellert; Buholzer, Seraina Flavia; Hardman, Elizabeth; Törnberg, Daniel; Pérez, David S.; van Smaalen, Kenneth; Onrust, Marisa; Maddison, Liivi; Appelberg, Oskar; Ehrlich, Hans Erik; Tamme, Kadri; Juhanson, Reile; Korjas, Jaanus; Jalkanen, Ville; Finni, Marleena; Reinikainen, Matti; Koskue, Talvikki; Czok, Marcelina; Zatorski, Pawel; Doroba, Oliwia; Kudlinski, Bartosz; Nowak, Pawel; Bialka, Szymon; Kluzik, Anna; Baran, Hanna; Al Duhailib, Zainab; Hakeam, Hakeam A.; Alshahrani, Mohammed; Elfaki, Osama Ahmed; Alanazi, Fadah A.; Aldhahri, Rakan; Belkhouja, Khairallah; Alahmari, Ali; Alsayer, Rawabi M.; Friman, Ola; Balintescu, Anca; Krag, Mette (2026-08)
Avaa tiedosto
Lataukset:
08 / 2026
Acta Anaesthesiologica Scandinavica
e70290
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202606308057
https://urn.fi/URN:NBN:fi:tuni-202606308057
Kuvaus
Peer reviewed
Tiivistelmä
Background: Feeding intolerance is common in intensive care unit (ICU) patients, but evidence supporting prokinetic use is limited. We aimed to provide international epidemiological data on the use of prokinetic agents in adult ICU patients and to explore potential associations with patient-important outcomes. Methods: We conducted an inception cohort study between August 2024 and March 2025 in acutely admitted ICU patients in 56 ICUs across 11 countries. The primary outcome was the proportion of patients receiving prokinetic agents. Secondary outcomes included associations with baseline characteristics, serious adverse events (SAEs), days alive out of ICU/hospital, days alive without life support and 90-day mortality. Associations with SAEs, baseline characteristics and mortality were assessed using pre-specified Cox regression models, while other secondary outcomes were evaluated using adjusted linear regression. All models were adjusted for country, severity of illness, number of comorbidities, surgery and ICU admission type. Results: Among 1440 ICU patients (median age 64 years, 56.9% male), 187 (13.0%; 95% confidence interval [CI] 11.3–14.8) received prokinetic agents during ICU stay, most commonly metoclopramide (65%). Prior abdominal surgery was associated with the initiation of prokinetic agents (hazard ratio [HR] 1.81; 95% CI 1.17–2.79). Use of prokinetic agents was statistically significantly associated with a higher hazard of experiencing a SAE (HR 1.9; 95% CI 1.3–2.8), fewer days alive out of ICU (mean difference [MD] −7.6 days; 95% CI, −13.4 to −2.2) and hospital (−13.5 days; 95% CI −18.7 to −8.4), but not with 90-day mortality (HR 0.62; 95% CI 0.3–1.2). Conclusions: Prokinetic agents were used in 13% of ICU patients, most commonly metoclopramide and more often in those with prior abdominal surgery. Prokinetic use was associated with a higher hazard of experiencing SAEs and fewer days alive out of hospital/ICU.
Kokoelmat
- TUNICRIS-julkaisut [25020]