The relationship of gastrointestinal complications and ventilator related status with gastric residual volume in intensive care patients

Yıl 2021, , 157 - 163, 30.08.2021

Mustafa Kaçmaz , Fazilet Şahin Kocaöz , Dilek Destegül , Zeynep Yüksel Turhan , Muhammet Bayraktar

https://doi.org/10.30565/medalanya.868948

Öz

Aim: Our study aimed primarily to determine whether there was a relationship between total gastric residual volume (GRV) amounts and two different GRV thresholds and the development of gastrointestinal intolerance in patients on mechanical ventilation in the intensive care unit (ICU) and secondarily, to determine the effects of different GRV quantities on ventilator-related conditions (VAC).

Methods: Seventy patients above the age of 18 who were scheduled to be fed with enteral nutrition (EN) for at least three days, were divided into two groups including 35 patients according to GRV threshold values of 250 ml and 500 ml. The total amounts of GRV of the patients who did not exceed any of the two GRV thresholds during the follow-up period of 72 hours were recorded and calculated. For all patients, necessary data was recorded and high gastric residual volume rates (HGRV), times to reach target calories, mean GRV amounts, abdominal distension, vomiting, diarrhea, VAC and infection-related ventilator-related complications (IVAC) were all observed.

Results: Although there were statistically significant differences between the groups in terms of the HGRV rates and the HGRV rates exceeding the determined threshold values [p <0.05], there was no significant difference between the groups in terms of abdominal distension, vomiting, diarrhea, VAC and IVAC (p> 0.05).

Conclusion: The results of this study suggest that measuring the amount of GRV in intensive care patients fed by EN via the nasogastric tube in order to decide on gastrointestinal motility function and to reduce the complication rate, is not necessary.

Anahtar Kelimeler

Enteral nutrition, complications, critical care

Yoğun Bakım Hastalarında İki Farklı Gastrik Rezidüel Volümün Gastrointestinal Komplikasyon ve Ventilatör İlişkili Durum İle İlişkisi

Öz

Amaç: Çalışmamızın amacı, yoğun bakım ünitesinde solunumu mekanik ventilasyon ile sağlanan hastalarda, toplam gastrik kalıntı hacim miktarları ve iki farklı gastrik kalıntı hacmi eşiği ile gastrointestinal komplikasyon gelişimi arasında ilişki olup olmadığının tespiti, ikinci hedefimiz ise farklı gastrik kalıntı hacimlerinin, ventilatör ilişkili durumlar üzerindeki etkilerini belirlemektir.

Yöntem: Çalışmaya en az 3 gün enteral beslenme planlanan, 18 yaşın üzerindeki 70 adet yetişkin hasta dahil edildi. Birinci gruptaki 35 hastada gastrik kalıntı hacmi eşiği 250 ml, ikinci grupta ise 500 ml olarak belirlendi. İzlem süresi boyunca, belirlenen her iki gastrik kalıntı hacmi eşiğinden herhangi birini aşmamış olan hastaların, 72 saat boyunca kaydedilen gastrik kalıntı hacimlerinin toplam miktarı hesaplandı. Tüm hastaların yüksek gastrik kalıntı hacim oranları, hedef kaloriye ulaşma süreleri, ortalama mide kalıntı hacim miktarları, abdominal distansiyon, kusma, diyare, ventilatör ilişkili durum ve enfeksiyona bağlı ventilatör ilişkili komplikasyon oranları gözlendi.

Bulgular: Çalışmamızın sonunda, iki grup arasında yüksek gastrik kalıntı hacim oranları, belirlenen eşik değerini aşan yüksek gastrik kalıntı hacim oranları arasına, anlamlı bir fark oluşmasına rağmen (p<0.05), her iki grup arasında abdominal distansiyon, kusma, diyare, ventilatör ilişkili durum ve enfeksiyona bağlı ventilatör ilişkili komplikasyon açısından anlamlı bir fark yoktu (p >0.05).

Sonuç: Bu sonuçlar, enteral yolla beslenen yoğun bakım hastalarında, gastrointestinal motiliteyi ölçmek ve komplikasyon oranını azaltmak için gastrik kalıntı hacim miktarlarının ölçülmesinin gerekli olmadığı düşündürmektedir.

Anahtar Kelimeler

Enteral beslenme, komplikasyonlar, yoğun bakım

Kaynakça

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