Yoğun Bakım Hastalarında Abdominal Masajın Konstipasyon Parametreleri Üzerine Etkisi: Sistematik Bir Derleme

Öz

Amaç: Abdominal masaj, yoğun bakım ünitesinde sık görülen konstipasyon sorunları için kullanılan bir tedavidir. Bununla birlikte, yoğun bakım hastalarında abdominal masajın konstipasyon üzerindeki etkisini araştıran çalışmaların güncellenmiş bir derlemesine ihtiyaç vardır. Bu çalışmanın amacı, yoğun bakım ünitesinde konstipasyonu olan hastalarda abdominal masaj ile ilgili çalışmaları gözden geçirmektir. Gereç ve Yöntemler: Bu derleme Mayıs 2024 tarihinde elektronik veri tabanları (PubMed, Science Direct, Scopus, Web of Science) taranarak gerçekleştirilmiştir. Kalite değerlendirmesi için PEDro skalası kullanılmıştır. Bulgular: Mevcut derlemeye dokuz çalışma dahil edilmiştir. Dört makale “orta”, beş makale “iyi” kanıt düzeyindedir. Gastrik rezidüel hacim ölçümü en çok kullanılan yöntemdi. Abdominal çevre, abdominal distansiyon, kusma, Konstipasyon Risk Değerlendirme Ölçeği diğer sonuç ölçütleriydi. Abdominal masajın bu sonuç ölçümleri üzerinde anlamlı etkileri vardı (p<0,05). Sonuç: Abdominal masaj müdahalesinin karın çevresi, karın şişliği, dışkılama sıklığı ve süresi, konstipasyon sıklığı ve insidansı ve bağırsak sesleri üzerinde olumlu etkileri vardır. Abdominal masaj, yoğun bakım ünitelerinde yatan yetişkin hastalarda konstipasyonu güvenilir bir şekilde azaltabilir.

Anahtar Kelimeler

• Konstipasyon
• yoğun bakım
• masaj

The Effect of Abdominal Massage on Constipation Parameters in Intensive Care Patients: A Systematic Review

Öz

Objective: Abdominal massage is a therapy used for common constipation problems in the intensive care unit. However, an updated review of studies investigating the effect of abdominal massage on constipation in the intensive care unit patients is needed. To review the studies on abdominal massage in patients with constipation in the intensive care unit. Materials and Methods: This review was conducted in May 2024 by searching electronic databases (PubMed, Science Direct, Scopus, Web of Science). The PEDro scale was employed for quality assessment. Results: Nine studies were included in the present review. Four articles were “moderate”, five articles were “good” level of evidence. Gastric residual volume measure was the most used method. Abdominal circumference, abdominal distention, vomiting, Constipation Risk Assessment Scale were the other outcome measures. Abdominal massage had significant effects on these outcome measures (p<0.05). Conclusion: Abdominal massage intervention has positive effects on abdominal circumference, abdominal distention, frequency and duration of defecation, frequency and incidence of constipation, and bowel noises. Abdominal massage may reliably reduce constipation in adult patients hospitalized in intensive care units.

Anahtar Kelimeler

• Constipation
• critical care
• massage

Kaynakça

1. Ghochae A, Fshar MH, Amin G, Vakili MA, Nia SE, Sanagoo A, et al. The survey of the effect of ginger extract on gastric residual volume in mechanically ventilated patients hospitalized in the Intensive Care Units. Advances in Environmental Biology. 2013;7:3395.
2. Aaben C, Hammarqvist F, Mabesa T, Hardcastle TC. Complications relating to enteral and parenteral nutrition in trauma patients: a retrospective study at a level one trauma centre in South Africa. South Afr J Clin Nutr. 2015;28(2):62-8.
3. Yayla A, Özer N, Karaman Özlü Z. Nutrition in the Surgical Intensive Care Unit. Özer N, Editor. Ankara: Türkiye Klinikleri; 2019. 16-26 p.
4. Chen W-T, Du M-J, Chen Y-Z, Yuan D-Q. Factors influencing feeding intolerance in critically ill patients during enteral nutrition. Int J Clin Exp Med. 2019;12(7):7999-8003.
5. Tatsumi H. Enteral tolerance in critically ill patients. J Intensive Care. 2019;7(1):30.
6. Kosasih CE, Andriani AD, Lestari AA, Sekarjati FM, Iqomatulhaq H, Audini JJ, et al. Effects of abdominal massage to overcome gastrointestinal dysfunction in patients in intensive care unit: A literature review. Padjadjaran Acute Care Nursing Journal. 2019;1(1):60-7.
7. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79.
8. Yu T, Cai F, Jiang R. Effects of Early Bedside Cycle Exercise on Gastrointestinal Function in Intensive Care Unit Patients Receiving Mechanical Ventilation. Front Med (Lausanne). 2022;9:823067.

9. Uysal N, Eser I, Akpinar H. The Effect of Abdominal Massage on Gastric Residual Volume: A Randomized Controlled Trial. Gastroenterol Nurs. 2012;35(2):117-23.
10. Lämås K, Lindholm L, Stenlund H, Engström B, Jacobsson C. Effects of abdominal massage in management of constipation—A randomized controlled trial. Int J Nurs Stud. 2009;46(6):759-67.
11. Dehghan M, Fatehi poor A, Mehdipoor R, Ahmadinejad M. Does abdominal massage improve gastrointestinal functions of intensive care patients with an endotracheal tube?: A randomized clinical trial. Complement Ther Clin Pract. 2018;30:122-8.
12. Hami H, Waluyo A, Ohorella UB. The Beneficial Effects of Abdominal Massage on Constipation and Quality of Life: A Literatur Review. Indonesian Contemporary Nursing Journal (ICON Journal). 2020;4(2):72-82.
13. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.
14. Özden F, Özkeskin M, Tümtürk İ, Ezgin BD. The Effect of Kinesio Taping on Shoulder Symptoms in Patients with Stroke: A Systematic Review. Phys Occup Ther Geriatr. 2023;41(1):102-27.
15. Altun Ugras G, Yüksel S, Isik MT, Tasdelen B, Dogan H, Mutluay O. Effect of abdominal massage on bowel evacuation in neurosurgical intensive care patients. Nurs Crit Care. 2022;27(4):558-66.
16. Eskici İlgin V, Özer N. The Effect of Abdominal Massage on Discharge and Ventilator-Associated Pneumonia in Enterally Fed Patients Connected to Mechanical Ventilation: A Randomized Controlled Study. Dimens Crit Care Nurs. 2023;42(2):104-114.
17. Kahraman BB, Ozdemir L. The impact of abdominal massage administered to intubated and enterally fed patients on the development of ventilator-associated pneumonia: A randomized controlled study. Int J Nurs Stud. 2015;52(2):519-24.
18. Moseley AM, Herbert RD, Sherrington C, Maher CG. Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDro). Aust J Physiother. 2002;48(1):43-9.
19. Aldugiem M, Abdelkader A, El-Soussi A, Zeitoun T, Abdelkader FA, Abdelrahem ASA, et al. Effect of Abdominal Massage on Gastrointestinal Outcomes of Critical Ill Patients with Enteral Feeding. J Med Chem Sci. 2021;4(5):497-507.
20. Çetinkaya O, Ovayolu Ö, Ovayolu N. The Effect of Abdominal Massage on Enteral Complications in Geriatric Patients. SAGE Open Nurs. 2020;6:2377960820963772.
21. Ahmed Mohamed H, Hussein Bakr Z, Mohamed Naguib A. Effect of abdominal massage on gastrointestinal function among enterally fed critically ill patients. Egyptian Journal of Health Care. 2021;12(1):801-13.
22. Turan M, Cengiz Z. The effect of abdominal massage and in-bed ROM exercise on gastrointestinal complications and comfort in intensive care unit patients receiving enteral nutrition: A randomized controlled trial. Jpn J Nurs Sci. 2024;21(3):e12602.
23. Wang X, Sun J, Li Z, Luo H, Zhao M, Li Z, et al. Impact of abdominal massage on enteral nutrition complications in adult critically ill patients: A systematic review and meta-analysis. Complement Ther Med. 2022;64:102796.
24. NI MH, Santhi S, Nirmala V, Rani A. Effectiveness Of Gastrointestinal Massage On Abdominal Distension, Gastric Residual Content, And Gastrointestinal Function In Nasogastric Tube Patients Admitted To The Icu-A Systematic Review. Int Neurourol J. 2023;27(4):1235-40.
25. Uysal N. The effect of abdominal massage administered by caregivers on gastric complications occurring in patients intermittent enteral feeding – A randomized controlled trial. Eur J Integr Med. 2017;10:75-81.
26. Ilgin VE, Yayla A. The Effect of Abdominal Massage on Distension and Pain in Intubated Patients Receiving Enteral Nutrition in Neurosurgical Intensive Care Units in the Postoperative Period. Int J Caring Sci. 2023;16(3):1694-705.
27. Zhang W, Zhou W, Kong Y, Li Q, Huang X, Zhao B, et al. The effect of abdominal massage on enteral nutrition tolerance in patients on mechanical ventilation: A Randomized Controlled Study. Intensive Crit Care Nurs. 2023;75:103371.
28. Abdelhafez AI, Abd Elnaeem MM. Effect of Abdominal Massage on Gastrointestinal Complications and Intra-Abdominal Pressure of Critical-Enteral-Feed Patients: A Randomized Control Trial. Journal of Health, Medicine and Nursing. 2019;64(7):33-41.
29. Sinclair M. The use of abdominal massage to treat chronic constipation. J Bodyw Mov Ther. 2011;15(4):436-45.
30. Çevik K, Çetinkaya A, Yiğit Gökbel K, Menekşe B, Saza S, Tıkız C. The Effect of Abdominal Massage on Constipation in the Elderly Residing in Rest Homes. Gastroenterol Nurs. 2018;41(5):396-402.
31. Younis GA, Ahmed SES, Abo Seada AI. Effect of Abdominal Massage on the Occurrence of Constipation among Critically Ill Ventilated Patients at Intensive Care Unit. Tanta Scientific Nursing Journal. 2023;28(1):11-27.
32. Gu X, Zhang L, Yuan H, Zhang M. Analysis of the efficacy of abdominal massage on functional constipation: A meta-analysis. Heliyon. 2023;9(7):e18098.
33. Saeed Yousef Hassan Gafar S, El-aziz A, Wahdan W, Mohga Abd El-Aziz M, Kandeel NA. The Effect of Abdominal Massage on Gastric Residual Volume among Critically Ill Patients Receiving Enteral Feeding. Mansoura Nursing Journal. 2023;10(1):485-94.
34. Doğan İ G, Gürşen C, Akbayrak T, Balaban YH, Vahabov C, Üzelpasacı E, et al. Abdominal Massage in Functional Chronic Constipation: A Randomized Placebo-Controlled Trial. Phys Ther. 2022;102(7):pzac058.