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Binks R, De Luca E, Dierkes C, et al. Prevalence, clinical consequences and management of acute faecal incontinence with diarrhoea in the ICU: The FIRST™ Observational Study. J Intensive Care Soc. 2015;16(4):294-301doi: 10.1177/1751143715589327.
Binks, R., De Luca, E., Dierkes, C., Franci, A., Herrero, E., & Niederalt, G. (2015). Prevalence, clinical consequences and management of acute faecal incontinence with diarrhoea in the ICU: The FIRST™ Observational Study. Journal of the Intensive Care Society, 16(4), 294-301. https://doi.org/10.1177/1751143715589327
Binks, Rachel, et al. "Prevalence, clinical consequences and management of acute faecal incontinence with diarrhoea in the ICU: The FIRST™ Observational Study." Journal of the Intensive Care Society vol. 16,4 (2015): 294-301. doi: https://doi.org/10.1177/1751143715589327
Binks R, De Luca E, Dierkes C, Franci A, Herrero E, Niederalt G. Prevalence, clinical consequences and management of acute faecal incontinence with diarrhoea in the ICU: The FIRST™ Observational Study. J Intensive Care Soc. 2015 Nov;16(4):294-301. doi: 10.1177/1751143715589327. Epub 2015 Jun 30. PMID: 28979434; PMCID: PMC5606465.
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J Intensive Care Soc. 2015 Nov;16(4):294-301. doi: 10.1177/1751143715589327. Epub 2015 Jun 30.

Prevalence, clinical consequences and management of acute faecal incontinence with diarrhoea in the ICU: The FIRST™ Observational Study.

Journal of the Intensive Care Society

Rachel Binks, Enrico De Luca, Christine Dierkes, Andrea Franci, Eva Herrero, Georg Niederalt

Affiliations

  1. Airedale NHS Foundation Trust, West Yorkshire, UK.
  2. Policlinico Tor Vergata, Rome, Italy.
  3. Hospital Barmherzige Brüder, Regensburg, Germany.
  4. Azienda Ospedaliera Careggi, Florence, Italy.
  5. Hospital Universitario La Paz, Madrid, Spain.
  6. Universitätsklinikum, Regensburg, Germany.

PMID: 28979434 PMCID: PMC5606465 DOI: 10.1177/1751143715589327

Abstract

There are limited data on the incidence and management of acute faecal incontinence with diarrhoea in the ICU. The FIRST™ Observational Study was undertaken to obtain data on clinical practices used in the ICU for the management of acute faecal incontinence with diarrhoea in Germany, UK, Spain and Italy. ICU-hospitalised patients ≥18 years of age experiencing a second episode of acute faecal incontinence with diarrhoea in 24 h were recruited, and management practices of acute faecal incontinence with diarrhoea were recorded for up to 15 days. A total of 372 patients had complete data sets; the mean duration of study was 6.8 days. At baseline, 40% of patients experienced mild or moderate-to-severe skin excoriation, which increased to 63% in patients with acute faecal incontinence with diarrhoea lasting >15 days. At baseline, 27% of patients presented with a pressure ulcer, which increased to 37%, 45% and 49% at days 5, 10 and 15, respectively. Traditional methods (pads, sheets and tubes) were more commonly used compared to faecal management systems during days 1-4 (76% vs. 47% faecal management system), while the use of a faecal management system increased to 56% at days 5-9 and 61% at days 10-15. At baseline, only 26% of nurses were satisfied with traditional management methods compared to 69% with faecal management systems. For patients still experiencing acute faecal incontinence with diarrhoea after 15 days, 82% of nurses using a faecal management systems to manage acute faecal incontinence with diarrhoea were satisfied or very satisfied, compared to 37% using traditional methods. These results highlight that acute faecal incontinence with diarrhoea remains an important healthcare challenge in ICUs in Europe; skin breakdown and pressure ulcers remain common complications in patients with acute faecal incontinence with diarrhoea in the ICU.

Keywords: Acute faecal incontinence; ICU; faecal management system; prevalence; skin breakdown

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