A while back, I read an article in a great series from the Journal of Hospital Medicine called, “Things We Do For No Reason” (and they have a Twitter account too!) It’s a great series and there are a lot of articles applicable to the ICU. The series examines things that we in healthcare do, but for which there is actually no good evidence for. The article in question was on the use of docusate for the prevention or treatment of constipation.
This is a drug that used to be on my standard ICU order set. Everyone got it on admission to prevent constipation. But, it turns out that it doesn’t really work. In fact, it’s no better than placebo. So, I stopped ordering it. I took it out of my order set. I use other drugs (like senna and polyethylene glycol) to prevent and treat constipation.
And so I was really glad to see this Instagram post from Doc Schmidt, an actual gastroenterologist also supporting the practice of ditching docusate! Check out his post and read the paper for yourself. Then delete that from your order set.
critical care notes 