Poo in the ICU PK

Bowel management in the intensive care unit is a critical yet often overlooked aspect of patient care, directly impacting mechanical ventilation duration and infection rates. Constipation affects up to 83% of ICU patients due to factors like opioid use, immobility, and hypoperfusion, leading to diaphragmatic dysfunction and bacterial translocation. Conversely, diarrhea and fecal incontinence—driven by antibiotic use, sorbitol-based drug suspensions, and enteral feeds—compromise skin integrity and increase nursing workload. Effective management requires the implementation of structured bowel protocols and the early use of internal fecal management systems, such as Zassi or Flexi-Seal tubes, which offer a $50 per patient equipment saving over traditional pads. Integrating these assessments into daily rounds via the "FAST HUGS IN BEDS PLEASE" mnemonic ensures that clinicians address bowel function, the patient environment, and de-escalation of causative medications to improve functional outcomes.