Clinical Pharmacology & Biopharmaceutics
Open Access

Abstract

Acute faecal incontinence with diarrhoea (AFId) has been reported to affect up to 40% of patients in the ICU. The clinical challenges of AFId include the risk of perineal skin breakdown and cross contamination with nosocomial infections, such a Clostridium difficile. In addition, the management of AFId is a burden on nursing time and hospital resources. Despite these challenges, there is little information or evaluation of the prevalence, awareness and management of AFId currently and no standard clinical management. To address these issues, an international panel of intensive care specialists convened to develop a cross-sectional descriptive survey and to discuss the creation of AFId management recommendations. The collective knowledge of the specialists and literature searches from online medical databases were used to create a survey tool and a set of guidelines together with an accompanying management algorithm to aid health care providers to administer the most appropriate care to patients with AFId in the ICU. The guidelines have been specifically designed to take into account how patient severity and comorbidities, coupled with the common AFId-associated clinical complications, can affect management choices. A comprehensive review of the current choices of AFId management strategies, taking into account the spectrum of patient types and hospital economic limitations, has also been included as a reference guide for health care providers to administer the most appropriate care to their patients. It is hoped that the wider adoption of these recommendations will be a step forward in improving the current management of AFId in the ICU.

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