Hernández-Domínguez E, Alba-Cuevas SI, Novoa-Santander NL, López-Rodríguez C, Garduño-López J, Amezcua-Gutiérrez M

Language: Spanish
References: 33
Page: 444-452
PDF size: 318.38 Kb.

ABSTRACT

Introduction: enteral feeding intolerance continues to be a limiting factor in many patients in intensive care unit (UCI), which has generated the search for strategies that allow early detection, as well as the standardization of the evaluation of gastric funtions with anexamination of the abdomen at the patient's bed side. Traditionally, measurement of gastric residual volume by manual aspiration has been used as a metho d to monitor enteral feeding intolerance. In the search to improve safety and minimize complications in critically ill patients, determination of gastric residual volume by ultrasound could be a tool that allows the early diagnosis of enteral intolerance due to its high sensitivity and specificity to detect or rule out a full stomach in clinical scenarios in which the presence of gastric contents is uncertain. In addition to being highly reproducible, it can determine its correlation with Gastric residual volume by manual aspiration, it could also improve early detection in our unit and implement routine monitoring and treatment strategies that will benefit the patients. Objective: to correlate gastric residual volume measured by ultrasound and manual aspiration for gastric reserve volume estimation in patients with enteral feeding intolerance. Material and methods: descriptive, longitudinal, prospective study in patients admitted to the adult UCI of a tertiary hospital in Mexico City and in whom enteral feeding intolerance was documented their stay. We measured gastric residual volume using ultrasound and compared this measurement with manual aspiration for gastric reserve volume estimation. Results: we included 23 participants, 59 measurements of gastric residual volume were performed using ultrasound and then compared with manual aspiration for gastric reserve volume. Parametric tests of normality were carried out with Kolmogorov-Smirnov with normal distribution. Of the 23 participants, 52% men, 47% women, and all participants were fed with a nasogastric tube. The mean age of the included participants was 48 years, mean BMI 28.4 kg/m². The admission etiology was pneumonia 56.5% (N13), followed by cerebral vascular disease 26.1% (N6). The main comorbidities were obesity 34% (N8), systemic arterial hypertension 34% (N8), diabetes 21.79% (N5). Using the Pearson test, it was determined that there is a directly proportional correlation with a correlation coefficient of 0.97. Conclusions: the measurement of gastric residual volume by ultrasound is a reliable metho d to detect enteral intolerance early, with a high correlation and statistical significance. This represents benefits for the critically ill patient, since ultrasound at the point of care presents a strategy of cutting-edge, non-invasive that can be performed at the patient's bedside.

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