Sunday, March 26, 2006

Is the Gut working

Sunday March 26, 2006
Where is my food dude !!

Is the Gut working? : Bowel sounds are not a reliable indicator of gastrointestinal function in critical illness. Bowl sound requires the presence of movement, intestinal contents and intraluminal air. Normally air is swallowed and in ventilated patients, particularly if receiving high doses of sedation or neuromuscular blocking agents do not swallow air. Because of this bowl sounds may be absent in patients whose gastrointestinal tract is working normally.

Read this quote from study of 1479 patients -
Daily enteral feeding practice on the ICU, which also looked into the factors interfering with successful administration of enteral feed: "We also found that nurses tended to overestimate gastric retention as a risk factor and, more importantly, violated the protocol by discarding a gastric retention volume of less than 200 ml over 6 hours. This behavior might be the result of a misplaced ambition to achieve safer care. Although the measurement of gastric retention is an important tool for guaranteeing safe enteral feeding, no difference is reported between gastric tube and duodenal tube use among ICU patients in terms of aspiration and nosocomial pneumonia." It was recommended to give back gastric retention of less than 250 ml (per 6 hours).

Related previous pearl:
Is post pyloric feeding absolute ?

Reference: (Click to get article)
Daily enteral feeding practice on the ICU: attainment of goals and interfering factors - Critical Care 2005, 9:R218-R225