Evaluation of bedside ultrasound for gastric residual volume in mechanically ventilated patients and guidance on enteral nutrition(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2023年第7期
- Page:
- 862-867
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Evaluation of bedside ultrasound for gastric residual volume in mechanically ventilated patients and guidance on enteral nutrition
- Author(s):
- YU Xiaoqin; WANG Ke; HE Qi
- Chongqing Emergency Medical Center, the Fourth Peoples Hospital of Chongqing/ Chongqing University Central Hospital, Chongqing 400014, China
- Keywords:
- Keywords: mechanical ventilation enteral nutrition bedside ultrasound residual stomach volume
- PACS:
- R459.7
- DOI:
- DOI:10.3969/j.issn.1005-202X.2023.07.011
- Abstract:
- Abstract: Objective To explore the value of bedside ultrasound in the evaluation of gastric residual volume in mechanically ventilated patients and the adjustment of enteral nutrition (EN) support regimen. Methods A total of 95 patients receiving mechanical ventilation were treated with EN nasal feeding. Bedside ultrasound was used to evaluate the gastric residual volume during EN in ultrasound group (n=48), while traditional syringe aspiration was adopted in control group (n=47). The EN support regimen was adjusted according to the gastric residual volume. Two groups were compared in terms of EN condition (time-to-compliance, compliance rate in 72 h, interruption rate), time taken for gastric residual volume assessment, duration of mechanical ventilation, length of hospital stay, hospitalization cost, complication rate, nutritional status before and after EN ［albumin (ALB), transfertin (TFN), prealbumin (PAB)］, T cell subpopulations (CD3+, CD4+, CD8+), and intestinal barrier function indicators ［endotoxicity lipopolysaccharide (LPS), diamine oxidase (DAO), D-lactic acid (DLA)］. Results Ultrasound group was advantageous over control group in time-to-compliance, compliance rate in 72 h, EN interruption rate, assessment time, duration of mechanical ventilation, hospital stay and hospitalization cost (P<0.05). After EN, the levels of serum ALB, TFN, PAB, CD3+ and CD4+ were higher, while the levels of serum LPS, DAO and DLA were lower in ultrasound group than in control group (P<0.05). The incidences of abdominal distension, diarrhea, vomiting/reflux, intestinal hyperactivity or disappearance and ventilator associated pneumonia in ultrasound group were all lower than those in control group (P<0.05). Conclusion During EN nasal feeding in mechanically ventilated patients, the evaluation of gastric residual volume with bedside ultrasound is convenient and can guide EN more accurately, thereby effectively improving the nutritional status, immune function and intestinal barrier function, which is helpful to reduce the incidence of complications, promote rehabilitation and reduce hospitalization cost.
Last Update: 2023-07-15