When it comes to the prognosis for such patients, gastrointestinal dysfunction plays a critical part — it can easily worsen once it occurs, and eventually lead to death.
Earlier research has shown that rhubarb may be able to protect intestinal barrier function, prevent intestinal bacterial translocation, and encourage gastrointestinal peristalsis (involuntary movements of the digestive tract's longitudinal and circular muscles).
However, there have been few clinical studies on this, prompting researchers at the Second Military Medical University in Shanghai to conduct a study to assess rhubarb's impact on gastrointestinal dysfunction in critically ill patients.
They recruited 386 patients with grade I to III acute gastrointestinal injury (AGI) from June 2016 to May 2017, after which they divided them into two groups: 149 controls, and 219 treated with rhubarb.
They collected clinical data within the first 24 hours of the patients' ICU admission, then seven days after treatment. They also gathered survival data on the 28th day after ICU admission, as well as the lengths of the patients' respective ICU stays.
They found that the remission rate of feeding intolerance in the treatment group was markedly higher (77.9%) than in the control group (30.9%), and the former's rate of AGI improvement was also higher.
In addition, those treated with rhubarb had shorter stays in the ICU, "though there was no significant difference in 28-day mortality" between the two groups. There were also no serious adverse effects observed in either group.
Ruminations on rhubarb
The researchers wrote that the study might have been limited by the subjective evaluation of the patients' AGI grade, which lacked objective and quantitative indicators.
At the same time, there was an "inherent bias" in the data collection of retrospective studies: a few evaluation indicators, such as intra‑abdominal pressure and residual gastric volume, had been left out of the study.
The sample size was also relatively small, and the follow-up time was rather short.
In conclusion, the researchers wrote: "Rhubarb might significantly improve feeding tolerance and relieve gastrointestinal dysfunction in critically ill patients, without serious adverse reactions. (The study) provided proof for the treatment of gastrointestinal dysfunction with rhubarb during clinical practice.
"Multi‑centre double‑blind randomised controlled studies with larger sample sizes are needed to explore the efficacy of rhubarb in critically ill patients with gastrointestinal dysfunction."
Source: Chinese Medical Journal
Vol. 131, Issue 10
"Effect of Rhubarb on Gastrointestinal Dysfunction in Critically Ill Patients: A Retrospective Study Based on Propensity Score Matching"
Authors: Xian Zhang, et al.