Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device

Background: To assess the risk of aspiration, nutrient tolerance, and gastric emptying of patients in ICUs, gastric ultrasound can provide information about the gastric contents. Using established formulas, the gastric residual volume (GRV) can be calculated in a standardized way by measuring the ga...

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Autores principales:	Tizian Jahreis, Jessica Kretschmann, Nick Weidner, Thomas Volk, Andreas Meiser, Heinrich Volker Groesdonk
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	intensive care gastric ultrasound multi-organ point-of-care ultrasound (MOPOCUS) critical illness enteral nutrition Medicine R
Acceso en línea:	https://doaj.org/article/4f98dd46afcc42df8024d776b81543b4
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spelling	oai:doaj.org-article:4f98dd46afcc42df8024d776b81543b42021-11-11T17:31:24ZSonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device10.3390/jcm102148592077-0383https://doaj.org/article/4f98dd46afcc42df8024d776b81543b42021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4859https://doaj.org/toc/2077-0383Background: To assess the risk of aspiration, nutrient tolerance, and gastric emptying of patients in ICUs, gastric ultrasound can provide information about the gastric contents. Using established formulas, the gastric residual volume (GRV) can be calculated in a standardized way by measuring the gastric antrum. The purpose of this study was to determine the GRV in a cohort of enterally fed patients using a miniaturized ultrasound device to achieve knowledge about feasibility and the GRV over time during the ICU stay. The findings could contribute to the optimization of enteral nutrition (EN) therapy. Methods: A total of 217 ultrasound examinations with 3 measurements each (651 measurements in total) were performed twice daily (morning and evening) in a longitudinal observational study on 18 patients with EN in the interdisciplinary surgical ICU of Saarland University Medical Center. The measured values of the GRV were analyzed in relation to the clinical course, the nutrition, and other parameters. Results: Measurements could be performed without interrupting the flow of clinical care and without pausing EN. The GRV was significantly larger with sparsely auscultated bowel sounds than with normal and excited bowel sounds (<i>p</i> < 0.01). Furthermore, a significantly larger GRV was present when using a high-caloric/low-protein nutritional product compared to an isocaloric product (<i>p</i> = 0.02). The GRV at the morning and evening measurements showed no circadian rhythm. When comparing the first and last ultrasound examination of each patient, there was a tendency towards an increased GRV (<i>p</i> = 0.07). Conclusion: The GRV measured by miniaturized ultrasound devices can provide important information about ICU patients without restricting treatment procedures in the ICU. Measurements are possible while EN therapy is ongoing. Further studies are needed to establish gastric ultrasound as a management tool in nutrition therapy.Tizian JahreisJessica KretschmannNick WeidnerThomas VolkAndreas MeiserHeinrich Volker GroesdonkMDPI AGarticleintensive caregastric ultrasoundmulti-organ point-of-care ultrasound (MOPOCUS)critical illnessenteral nutritionMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4859, p 4859 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	intensive care gastric ultrasound multi-organ point-of-care ultrasound (MOPOCUS) critical illness enteral nutrition Medicine R
spellingShingle	intensive care gastric ultrasound multi-organ point-of-care ultrasound (MOPOCUS) critical illness enteral nutrition Medicine R Tizian Jahreis Jessica Kretschmann Nick Weidner Thomas Volk Andreas Meiser Heinrich Volker Groesdonk Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device
description	Background: To assess the risk of aspiration, nutrient tolerance, and gastric emptying of patients in ICUs, gastric ultrasound can provide information about the gastric contents. Using established formulas, the gastric residual volume (GRV) can be calculated in a standardized way by measuring the gastric antrum. The purpose of this study was to determine the GRV in a cohort of enterally fed patients using a miniaturized ultrasound device to achieve knowledge about feasibility and the GRV over time during the ICU stay. The findings could contribute to the optimization of enteral nutrition (EN) therapy. Methods: A total of 217 ultrasound examinations with 3 measurements each (651 measurements in total) were performed twice daily (morning and evening) in a longitudinal observational study on 18 patients with EN in the interdisciplinary surgical ICU of Saarland University Medical Center. The measured values of the GRV were analyzed in relation to the clinical course, the nutrition, and other parameters. Results: Measurements could be performed without interrupting the flow of clinical care and without pausing EN. The GRV was significantly larger with sparsely auscultated bowel sounds than with normal and excited bowel sounds (<i>p</i> < 0.01). Furthermore, a significantly larger GRV was present when using a high-caloric/low-protein nutritional product compared to an isocaloric product (<i>p</i> = 0.02). The GRV at the morning and evening measurements showed no circadian rhythm. When comparing the first and last ultrasound examination of each patient, there was a tendency towards an increased GRV (<i>p</i> = 0.07). Conclusion: The GRV measured by miniaturized ultrasound devices can provide important information about ICU patients without restricting treatment procedures in the ICU. Measurements are possible while EN therapy is ongoing. Further studies are needed to establish gastric ultrasound as a management tool in nutrition therapy.
format	article
author	Tizian Jahreis Jessica Kretschmann Nick Weidner Thomas Volk Andreas Meiser Heinrich Volker Groesdonk
author_facet	Tizian Jahreis Jessica Kretschmann Nick Weidner Thomas Volk Andreas Meiser Heinrich Volker Groesdonk
author_sort	Tizian Jahreis
title	Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device
title_short	Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device
title_full	Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device
title_fullStr	Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device
title_full_unstemmed	Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device
title_sort	sonographic evaluation of gastric residual volume during enteral nutrition in critically ill patients using a miniaturized ultrasound device
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/4f98dd46afcc42df8024d776b81543b4
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Sonographic Evaluation of Gastric Residual Volume during Enteral Nutrition in Critically Ill Patients Using a Miniaturized Ultrasound Device

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