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Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study
There are few reports describing the association of naldemedine with defecation in critically ill patients with opioid-induced constipation. The purpose of this study was to determine whether naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipatio...
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Published in: | PloS one 2024-01, Vol.19 (1), p.e0295952-e0295952 |
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description | There are few reports describing the association of naldemedine with defecation in critically ill patients with opioid-induced constipation. The purpose of this study was to determine whether naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.
In this retrospective cohort study, patients admitted to the Intensive Care Unit (ICU) without defecation for 48 hours while receiving opioids were eligible for enrollment. The primary endpoint was the time of the first defecation within 96 hours after inclusion. Secondary endpoints included presence of diarrhea, duration of mechanical ventilation, ICU length of stay, ICU mortality, and in-hospital mortality. The Cox proportional hazard regression analysis with time-dependent covariates was used to evaluate the association naldemedine with earlier defecation.
A total of 875 patients were enrolled and were divided into 63 patients treated with naldemedine and 812 patients not treated. Defecation was observed in 58.7% of the naldemedine group and 48.8% of the no-naldemedine group during the study (p = 0.150). The naldemedine group had statistically significantly prolonged duration of mechanical ventilation (8.7 days vs 5.5 days, p < 0.001) and ICU length of stay (11.8 days vs 9.2 days, p = 0.001) compared to the no-naldemedine group. However, the administration of naldemedine was significantly associated with earlier defecation [hazard ratio:2.53; 95% confidence interval: 1.71-3.75, p < 0.001].
The present study shows that naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation. |
doi_str_mv | 10.1371/journal.pone.0295952 |
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In this retrospective cohort study, patients admitted to the Intensive Care Unit (ICU) without defecation for 48 hours while receiving opioids were eligible for enrollment. The primary endpoint was the time of the first defecation within 96 hours after inclusion. Secondary endpoints included presence of diarrhea, duration of mechanical ventilation, ICU length of stay, ICU mortality, and in-hospital mortality. The Cox proportional hazard regression analysis with time-dependent covariates was used to evaluate the association naldemedine with earlier defecation.
A total of 875 patients were enrolled and were divided into 63 patients treated with naldemedine and 812 patients not treated. Defecation was observed in 58.7% of the naldemedine group and 48.8% of the no-naldemedine group during the study (p = 0.150). The naldemedine group had statistically significantly prolonged duration of mechanical ventilation (8.7 days vs 5.5 days, p < 0.001) and ICU length of stay (11.8 days vs 9.2 days, p = 0.001) compared to the no-naldemedine group. However, the administration of naldemedine was significantly associated with earlier defecation [hazard ratio:2.53; 95% confidence interval: 1.71-3.75, p < 0.001].
The present study shows that naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0295952</identifier><identifier>PMID: 38170714</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analgesics, Opioid - therapeutic use ; Analysis ; Anesthesia ; Antibiotics ; Biology and Life Sciences ; Care and treatment ; Cohort analysis ; Cohort Studies ; Complications and side effects ; Constipation ; Constipation - chemically induced ; Constipation - drug therapy ; Critical care ; Critical Illness ; Critically ill ; Defecation ; Diagnosis ; Diarrhea ; Enteral nutrition ; Fentanyl ; Hospital patients ; Humans ; Intensive care ; Laxatives ; Mechanical ventilation ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Missing data ; Morphine ; Mortality ; Naltrexone - adverse effects ; Narcotic Antagonists - pharmacology ; Narcotics ; Nutrition ; Opioid-Induced Constipation - drug therapy ; Opioids ; Ostomy ; Patient admissions ; Regression analysis ; Retrospective Studies ; Risk factors ; Social Sciences ; Statistical analysis ; Time dependence ; Ventilation ; Ventilators</subject><ispartof>PloS one, 2024-01, Vol.19 (1), p.e0295952-e0295952</ispartof><rights>Copyright: © 2024 Nishiyama et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Nishiyama et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Nishiyama et al 2024 Nishiyama et al</rights><rights>2024 Nishiyama et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-c8eceeacb0bd73f5e35dec50dcbe46dc4f5bde999f10d15bba2e750bc5a029e3</cites><orcidid>0000-0003-2148-5556 ; 0000-0001-6673-5630 ; 0000-0002-0184-0381</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3069202238/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3069202238?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,38516,43895,44590,53791,53793,74412,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38170714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>de Barros, Guilherme Antonio Moreira</contributor><creatorcontrib>Nishiyama, Seiya</creatorcontrib><creatorcontrib>Uchino, Shigehiko</creatorcontrib><creatorcontrib>Sasabuchi, Yusuke</creatorcontrib><creatorcontrib>Masuyama, Tomoyuki</creatorcontrib><creatorcontrib>Lefor, Alan Kawarai</creatorcontrib><creatorcontrib>Sanui, Masamitsu</creatorcontrib><title>Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>There are few reports describing the association of naldemedine with defecation in critically ill patients with opioid-induced constipation. The purpose of this study was to determine whether naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.
In this retrospective cohort study, patients admitted to the Intensive Care Unit (ICU) without defecation for 48 hours while receiving opioids were eligible for enrollment. The primary endpoint was the time of the first defecation within 96 hours after inclusion. Secondary endpoints included presence of diarrhea, duration of mechanical ventilation, ICU length of stay, ICU mortality, and in-hospital mortality. The Cox proportional hazard regression analysis with time-dependent covariates was used to evaluate the association naldemedine with earlier defecation.
A total of 875 patients were enrolled and were divided into 63 patients treated with naldemedine and 812 patients not treated. Defecation was observed in 58.7% of the naldemedine group and 48.8% of the no-naldemedine group during the study (p = 0.150). The naldemedine group had statistically significantly prolonged duration of mechanical ventilation (8.7 days vs 5.5 days, p < 0.001) and ICU length of stay (11.8 days vs 9.2 days, p = 0.001) compared to the no-naldemedine group. However, the administration of naldemedine was significantly associated with earlier defecation [hazard ratio:2.53; 95% confidence interval: 1.71-3.75, p < 0.001].
The present study shows that naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.</description><subject>Analgesics, Opioid - therapeutic use</subject><subject>Analysis</subject><subject>Anesthesia</subject><subject>Antibiotics</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Constipation</subject><subject>Constipation - chemically induced</subject><subject>Constipation - drug therapy</subject><subject>Critical care</subject><subject>Critical Illness</subject><subject>Critically ill</subject><subject>Defecation</subject><subject>Diagnosis</subject><subject>Diarrhea</subject><subject>Enteral nutrition</subject><subject>Fentanyl</subject><subject>Hospital patients</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Laxatives</subject><subject>Mechanical ventilation</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>Missing data</subject><subject>Morphine</subject><subject>Mortality</subject><subject>Naltrexone - adverse effects</subject><subject>Narcotic Antagonists - pharmacology</subject><subject>Narcotics</subject><subject>Nutrition</subject><subject>Opioid-Induced Constipation - drug therapy</subject><subject>Opioids</subject><subject>Ostomy</subject><subject>Patient admissions</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Social Sciences</subject><subject>Statistical analysis</subject><subject>Time dependence</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>COVID</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11rFDEUhgdRbK3-A9GAIArumo-ZycQbKcWPQrGgxduQSc7sZslOpkmmun_FX2u2Oy1d6YXMRYbked_DeZNTFM8JnhPGyfuVH0Ov3HzwPcwxFZWo6IPikAhGZzXF7OGd_4PiSYwrjCvW1PXj4oA1hGNOysPizzflDKzB2B6QjUjF6LVVCQz6ZdMSgQrOQkAGOtAqWd8j2yMdbLJaObdB1jk05APoU9xJ_GC9NTPbm1FnG-37mOxwrf2AjlGAFHwcQCd7Be9QtP3CwUxnfS6j_dKHhGIazeZp8ahTLsKzaT0qLj5_ujj5Ojs7_3J6cnw203VJ00w3oAGUbnFrOOsqYJUBXWGjWyhro8uuag0IITqCDanaVlHgFW51pXJqwI6Klzvbwfkop1SjZLgWFFPKmkyc7gjj1UoOwa5V2EivrLze8GEhVch5OJBlzTWvOC8pr0rRYsXLjpqmabRpKLmu9nGqNrY59W3bQbk90_2T3i7lwl9JgnnNBCuzw5vJIfjLEWKSaxs1OKd68GOUVBBMBMZYZPTVP-j97U3UQuUObN_5XFhvTeUx5w3BggqWqfk9VP7y67H5jqGzeX9P8HZPkJkEv9NCjTHK0x_f_589_7nPvr7DLkG5tIzejdv3FffBcgfq_N5igO42ZYLldoRu0pDbEZLTCGXZi7s3dCu6mRn2F021Gxs</recordid><startdate>20240103</startdate><enddate>20240103</enddate><creator>Nishiyama, Seiya</creator><creator>Uchino, Shigehiko</creator><creator>Sasabuchi, Yusuke</creator><creator>Masuyama, Tomoyuki</creator><creator>Lefor, Alan Kawarai</creator><creator>Sanui, Masamitsu</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>COVID</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2148-5556</orcidid><orcidid>https://orcid.org/0000-0001-6673-5630</orcidid><orcidid>https://orcid.org/0000-0002-0184-0381</orcidid></search><sort><creationdate>20240103</creationdate><title>Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study</title><author>Nishiyama, Seiya ; Uchino, Shigehiko ; Sasabuchi, Yusuke ; Masuyama, Tomoyuki ; Lefor, Alan Kawarai ; Sanui, Masamitsu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-c8eceeacb0bd73f5e35dec50dcbe46dc4f5bde999f10d15bba2e750bc5a029e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Analgesics, Opioid - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nishiyama, Seiya</au><au>Uchino, Shigehiko</au><au>Sasabuchi, Yusuke</au><au>Masuyama, Tomoyuki</au><au>Lefor, Alan Kawarai</au><au>Sanui, Masamitsu</au><au>de Barros, Guilherme Antonio Moreira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-01-03</date><risdate>2024</risdate><volume>19</volume><issue>1</issue><spage>e0295952</spage><epage>e0295952</epage><pages>e0295952-e0295952</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>There are few reports describing the association of naldemedine with defecation in critically ill patients with opioid-induced constipation. The purpose of this study was to determine whether naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.
In this retrospective cohort study, patients admitted to the Intensive Care Unit (ICU) without defecation for 48 hours while receiving opioids were eligible for enrollment. The primary endpoint was the time of the first defecation within 96 hours after inclusion. Secondary endpoints included presence of diarrhea, duration of mechanical ventilation, ICU length of stay, ICU mortality, and in-hospital mortality. The Cox proportional hazard regression analysis with time-dependent covariates was used to evaluate the association naldemedine with earlier defecation.
A total of 875 patients were enrolled and were divided into 63 patients treated with naldemedine and 812 patients not treated. Defecation was observed in 58.7% of the naldemedine group and 48.8% of the no-naldemedine group during the study (p = 0.150). The naldemedine group had statistically significantly prolonged duration of mechanical ventilation (8.7 days vs 5.5 days, p < 0.001) and ICU length of stay (11.8 days vs 9.2 days, p = 0.001) compared to the no-naldemedine group. However, the administration of naldemedine was significantly associated with earlier defecation [hazard ratio:2.53; 95% confidence interval: 1.71-3.75, p < 0.001].
The present study shows that naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38170714</pmid><doi>10.1371/journal.pone.0295952</doi><tpages>e0295952</tpages><orcidid>https://orcid.org/0000-0003-2148-5556</orcidid><orcidid>https://orcid.org/0000-0001-6673-5630</orcidid><orcidid>https://orcid.org/0000-0002-0184-0381</orcidid><oa>free_for_read</oa></addata></record> |
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recordid | cdi_plos_journals_3069202238 |
source | PubMed Central Free; ProQuest - Publicly Available Content Database; Coronavirus Research Database |
subjects | Analgesics, Opioid - therapeutic use Analysis Anesthesia Antibiotics Biology and Life Sciences Care and treatment Cohort analysis Cohort Studies Complications and side effects Constipation Constipation - chemically induced Constipation - drug therapy Critical care Critical Illness Critically ill Defecation Diagnosis Diarrhea Enteral nutrition Fentanyl Hospital patients Humans Intensive care Laxatives Mechanical ventilation Medical research Medicine and Health Sciences Medicine, Experimental Missing data Morphine Mortality Naltrexone - adverse effects Narcotic Antagonists - pharmacology Narcotics Nutrition Opioid-Induced Constipation - drug therapy Opioids Ostomy Patient admissions Regression analysis Retrospective Studies Risk factors Social Sciences Statistical analysis Time dependence Ventilation Ventilators |
title | Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T06%3A31%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Naldemedine%20is%20associated%20with%20earlier%20defecation%20in%20critically%20ill%20patients%20with%20opioid-induced%20constipation:%20A%20retrospective,%20single-center%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Nishiyama,%20Seiya&rft.date=2024-01-03&rft.volume=19&rft.issue=1&rft.spage=e0295952&rft.epage=e0295952&rft.pages=e0295952-e0295952&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0295952&rft_dat=%3Cgale_plos_%3EA778109293%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c642t-c8eceeacb0bd73f5e35dec50dcbe46dc4f5bde999f10d15bba2e750bc5a029e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3069202238&rft_id=info:pmid/38170714&rft_galeid=A778109293&rfr_iscdi=true |