Objective: To identify the causes of diarrhea during mechanical ventilation.
Methods: We reviewed 56 cases, who have been mechanically ventilated for more than 48 hours, and also received both enteral and parental nutritional support in our RICU.
Results: 33 (57%) patients developed ventilator-associated pneumonia. 19 (33%) patients suffered from diarrhea, lasted 13 days on average. Spores with large quantities were found in stools of 8 patients, with hypha in three patients. There was imbalance of bacteria in faeces in 4 cases, manifested by decreases in rods and increases in cocci, in which E. faecalis were present in 3 patients. 9 patients suffered from diarrhea with no evidence rate of abnormalities in their faeces. Diarrhea was treated by adjustment of food temperature and rate of feeding. it is confirmed by Logistic regression that diarrhea during mechanical ventilation was correlated with ventilator associated pneumonia (VAP).
Conclusions: Diarrhea in mechanical ventilated patients in our RICU were attributed mainly to improper administration of enteral nutrition, disturbances of the microenvironment of the intestines, including fungal infection, imbalance between coccus and rod, even E. faecalis colonization. Limitation of broad-spectrum antibiotics administration, VAP control, and proper administration of formula are strongly recommended.