Table 4 Studies about opioid antagonists in the ICU

Liu et al. [79]

RCT

9 OIC patients

NTX (n = 6) vs placebo (n = 3)

To evaluate the effect of low doses of NTX on constipation and analgesia

Bowel frequency improved but reversal of analgesia also occurred

Meissner et al. [76]

RCT

84 mechanically ventilated patients received intravenous infusion of fentanyl

NTX (n = 38) vs placebo (n = 43)

To study the effect of NTX on the gastric tube reflux, the occurrence of pneumonia, and the time to first defecation

The administration of NTX was effective to reduce gastric tube reflux and frequency of pneumonia, but the first defecation in the two groups did not differ

Arpino et al. [78]

RS

26 OIC patients in the ICU received opioids at least 48 h prior to NTX

Comparison between before and after NTX administration

To assess the safety of NTX in the ICU

The administration of NTX was not associated with changes in sedation score, vital signs, fentanyl dose, midazolam dose or propofol dose

Gibson et al. [77]

RS

16 OIC patients received scheduled doses of opioids for pain control in the MICU

Before and after during NTX treatment

To evaluate the efficacy and safety of NTX before and after during naloxone treatment

NTX appeared to be effective and safe for the treatment of OIC in the MICU. NTX had no reversal of analgesic

Merchan et al. [81]

RS

100 OIC patients in the MICU

NTX (n = 52) vs MNTX (n = 48)

To assess the effectiveness and safety of NTX and MNTX for the treatment of OIC

MNTX and NTX appear to be effective and safe for the treatment of OIC. The median times to first BM for NTX and MNTX were 30 and 24 h (P = 0.165)

Patel et al. [73]

RCT

84 OIC patients in the ICU with opioid analgesics for at least 24 h

MNTX (n = 41) vs placebo (n = 43)

To investigate whether MNTX alleviates OIC in critically ill patients

There was no evidence to support the addition of MNTX to regular laxatives for the treatment of OIC in the ICU

Sawh et al. [85]

RS

15 OIC patients in the ICU

MNTX (n = 7) vs conventional rescue therapy (n = 8) to treat the OIC in the ICU

To compare the effect of MNTX and conventional rescue therapy in the ICU

MNTX was effective in the treatment of OIC patients

Masding et al. [86]

ROS

827 patients in the cardiothoracic ICU

NA

the prevalence of OIC in a large cardiothoracic ICU and the use of naloxegol

Nearly 20% of ICU patients had OIC and use of naloxegol could reduce the prevalence of OIC

Phase 3 [87]

RCT

350 ICU patients received opioids at least 48 h hours

Polyethylene glycol vs naloxegol

To investigate whether naloxegol is superior to osmotic laxatives for refractory constipation in ICU patients

The study had withdrawn