{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:05:16Z","timestamp":1784693116155,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Feeding intolerance is common in intensive care unit (ICU) patients, but evidence supporting prokinetic use is limited. We aimed to provide international epidemiological data on the use of prokinetic agents in adult ICU patients and to explore potential associations with patient\u2010important outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted an inception cohort study between August 2024 and March 2025 in acutely admitted ICU patients in 56 ICUs across 11 countries. The primary outcome was the proportion of patients receiving prokinetic agents. Secondary outcomes included associations with baseline characteristics, serious adverse events (SAEs), days alive out of ICU\/hospital, days alive without life support and 90\u2010day mortality. Associations with SAEs, baseline characteristics and mortality were assessed using pre\u2010specified Cox regression models, while other secondary outcomes were evaluated using adjusted linear regression. All models were adjusted for country, severity of illness, number of comorbidities, surgery and ICU admission type.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 1440 ICU patients (median age 64\u2009years, 56.9% male), 187 (13.0%; 95% confidence interval [CI] 11.3\u201314.8) received prokinetic agents during ICU stay, most commonly metoclopramide (65%). Prior abdominal surgery was associated with the initiation of prokinetic agents (hazard ratio [HR] 1.81; 95% CI 1.17\u20132.79). Use of prokinetic agents was statistically significantly associated with a higher hazard of experiencing a SAE (HR 1.9; 95% CI 1.3\u20132.8), fewer days alive out of ICU (mean difference [MD] \u22127.6\u2009days; 95% CI, \u221213.4 to \u22122.2) and hospital (\u221213.5\u2009days; 95% CI \u221218.7 to \u22128.4), but not with 90\u2010day mortality (HR 0.62; 95% CI 0.3\u20131.2).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Prokinetic agents were used in 13% of ICU patients, most commonly metoclopramide and more often in those with prior abdominal surgery. Prokinetic use was associated with a higher hazard of experiencing SAEs and fewer days alive out of hospital\/ICU.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aas.70290","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:00:13Z","timestamp":1782284413000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Prokinetic Agents in Adult\n ICU<\/scp>\n Patients: An International Inception Cohort Study (\n PATIENCE<\/scp>\n )"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3076-0794","authenticated-orcid":false,"given":"Vera","family":"Crone","sequence":"first","affiliation":[{"name":"Department of Intensive Care Holb\u00e6k Hospital Holb\u00e6k Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6378-9673","authenticated-orcid":false,"given":"Morten Hylander","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital\u2014Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-7655","authenticated-orcid":false,"given":"Anders","family":"Granholm","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital\u2014Rigshospitalet Copenhagen Denmark"},{"name":"Section of Biostatistics, Department of Public Health University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Perner","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital\u2014Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Alhazzani","sequence":"additional","affiliation":[{"name":"Research and Innovation Institute Ministry of Defense Health Services Riyadh Saudi Arabia"},{"name":"Critical Care and Internal Medicine Department, College of Medicine Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1472-016X","authenticated-orcid":false,"given":"Laura Rindom","family":"Krogsgaard","sequence":"additional","affiliation":[{"name":"Gastrounit, Section of Gastroenterology Hvidovre Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Al\u2010Fares","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Critical Care Medicine and Pain Medicine Al\u2010Amiri Hospital, Ministry of Health Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"H\u00e4stbacka","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Tampere University Hospital, Wellbeing Services County of Pirkanmaa and Tampere University Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9500-9080","authenticated-orcid":false,"given":"Marlies","family":"Ostermann","sequence":"additional","affiliation":[{"name":"Department of Critical Care King's College London, Guy's and St. Thomas' NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen A.","family":"Pfortmueller","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Inselspital, Bern University Hospital and University of Bern Bern 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d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"van Smaalen","sequence":"additional","affiliation":[{"name":"Department of Critical Care University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Onrust","sequence":"additional","affiliation":[{"name":"Department of Critical Care University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liivi","family":"Maddison","sequence":"additional","affiliation":[{"name":"Intensive Care Centre North Estonian Medical Centre Tallinn Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Appelberg","sequence":"additional","affiliation":[{"name":"Intensive Care Centre North Estonian Medical Centre Tallinn 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