Motor abnormalities of digestive and urinary tracts in patients on ventilator for acute exacerbation of chronic obstructive pulmonary disease

Abstract

The frequency of digestive motor abnormalities was evaluated in 30 consecutive patients ventilated for acute exacerbation of chronic obstructive pulmonary disease. Total and segmental colonic transit times were investigated by radiopaque marker transit time in all patients. Eleven patients also had rectoanal and esophageal manometries, combined with urodynamic study in eight cases. The results show that total radiopaque marker transit time was increased, 201±14 hr (mean±se), with two main regions of decreased transit rates: the right colon (42% of global transit time) and the rectosigmoid (36%). Delayed transit of radiopaque markers in nine of 11 cases was combined with esophageal motor dysfunction and absence of rectoanal inhibitory reflex. In three of eight cases there was disinhibition of urinary bladder contraction, and micturition was impossible in two of eight cases. We conclude that patients on ventilator for exacerbation of chronic obstructive pulmonary disease always have a delayed colonic transit time with diffuse digestive and bladder motor dysfunction.