{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:01:05Z","timestamp":1785445265231,"version":"3.56.0"},"reference-count":67,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Constipation affects half of critically ill children in pediatric intensive care units (PICUs). The primary aim was to identify factors associated with constipation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A multicenter retrospective review of nutrition support, medication, and defecation in critically ill children in five PICUs with an expected length of stay greater than 48\u2009h.\n                      <jats:italic>Constipation:<\/jats:italic>\n                      defined as \u22653 days from admission without a bowel movement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 250 children, mean age 38.1\u2009\u00b1\u200956.2 months, of which 155 (62%) were male. Among the 47% (117\/250) of children who were constipated, compared to no constipation group, the mean time to passage of first stool was 6.0\u2009\u00b1\u20093.7 days vs.1.0\u2009\u00b1\u20091.1 days, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Children with and without constipation achieved 43% of energy and 36% of protein recommendations, compared with 67% and 56%, respectively. In a multivariate analysis, factors that increased the risk of constipation included children prescribed opioids and muscle relaxants, a cardiac diagnosis (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and sex (males) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04). Conversely, children had a reduced risk of constipation if they were following a bowel\u2010management protocol (30% reduced risk) or prescribed laxatives (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective study, the incidence of constipation among children admitted to the PICU was 47%. Risk factors for constipation included the use of opioid and muscle relaxants, a cardiac diagnosis, and sex (males). Children with constipation had significantly lower energy and protein intake during their PICU admission. Implementation of a bowel\u2010management protocol and prescription of laxatives was associated with a reduced\u00a0risk of constipation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ncp.70155","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:24:36Z","timestamp":1784697876000},"page":"1191-1204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with constipation in critically ill children: A retrospective study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-121X","authenticated-orcid":false,"given":"Luise V.","family":"Marino","sequence":"first","affiliation":[{"name":"Southwest Yorkshire Partnership NHS Foundation Trust Wakefield UK"},{"name":"School of Medicine University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-392X","authenticated-orcid":false,"given":"Brittany","family":"Rothman","sequence":"additional","affiliation":[{"name":"Department of Dietetics Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Department of Dietetics Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Sheppard","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition and Dietetics Children's Health Ireland at Crumlin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Dr Meredith Kinoshita. 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