Summary
This systematic review and meta-analysis examined the clinical impact of bowel protocols in critically ill adults by synthesising evidence from four randomised controlled trials (n=534). Bowel protocols demonstrated only a trend toward reduced constipation (RR 0.50, p=0.05, low-quality evidence) with no statistically significant improvements in enteral feed tolerance or mechanical ventilation duration. The authors conclude that larger, well-designed trials are needed to establish whether bowel protocols meaningfully improve patient-important outcomes in the intensive care setting.
UK applicability
Findings are directly applicable to UK ICU practice, as constipation management protocols are widely implemented in UK critical care units. The low quality of evidence and lack of clear benefit may inform local clinical guideline development and suggest prioritisation of rigorous UK-based trials to better establish the role of bowel protocols in British critical care.
Key measures
Risk ratio for constipation (0.50, 95% CI 0.25–1.01), risk ratio for reduced enteral feed tolerance (0.94, 95% CI 0.62–1.42), mean difference in mechanical ventilation duration (0.01 days, 95% CI –2.67 to 2.69)
Outcomes reported
The study measured the effect of bowel protocols on constipation incidence, enteral feed tolerance, and duration of mechanical ventilation in critically ill adults. Outcomes were synthesised from four randomised controlled trials including 534 patients.
Topic tags
Dig deeper with Pulse AI.
Pulse AI has read the whole catalogue. Ask about this record, its theme, or how the findings apply to UK farming and policy — every answer cites the underlying studies.