Application of bedside ultrasound monitoring gastric residual volume and motilite index in critical illness patients with enteral nutrition
Objective:To study the effect and possible mechanism of bedside ultrasound monitoring gastric re-sidual volume(GRV)and motilite index(MI)in enteral nutrition support therapy in critical illness patients,and provide reference for the guidance of enteral nutrition support therapy in critical illness patients.Methods:A total of 100 critical illness patients requiring enteral nutrition support therapy from July 2021 to December 2022 were di-vided into study group(50 cases)and control group(50 cases).Patients in the control group monitored GRV by gastric tube extraction,and adjusted enteral nutrition support therapy scheme according to GRV.Patients in the study group monitored GRV and MI by ultrasound combined,and adjusted enteral nutrition support therapy scheme according to GRV and MI.Then the serum inflammatory factors,humoral immunity,cellular immunity,intestinal mucosal barrier function,gastrointestinal hormones and nutritional indexes were compared before and after treatment between two groups.The feeding-related complications and infection-related complications were analyzed.Results:After treatment,the serum C-reactive protein,interleukin-6,and tumor necrosis factor-a in the study group were significantly lower than those in the control group during the same period,and the interleukin-10 was significantly higher than that in the control group(P＜0.05).After treatment,the levels of immunoglobulin A,immunoglobulin G,and immunoglobulin M in the study group were significantly higher than those in the con-trol group during the same period(P＜0.05).After treatment,the CD3+,CD4+,and CD4+/CD8+levels in the study group were significantly higher than those in the control group during the same period(P＜0.05),and the CD8+level was significantly lower than that in the control group(P＜0.05).After treatment,the levels of serum endotoxin,D-lactate,and diamine oxidase in the study group were significantly lower than those in the control group(P＜0.05).After treatment,the levels of motilin and serotonin in the study group were significantly higher than those in the control group(P＜0.05),and the level of vasoactive peptides was significantly lower than that in the control group(P＜0.05).After treatment,the serum albumin,prealbumin,and transferrin levels in the stud-y group were significantly higher than those in the control group during the same period(P＜0.05).The intra-ab-dominal pressure,target feeding time,mechanical ventilation time,and ICU hospitalization time in the study group were significantly lower than those in the control group(P＜0.05).The incidence of feeding-related compli-cations in the study group was 20.00％,which was significantly lower than 68.00％in the control group(P＜0.05).The incidence of infection-related complications in the study group was 12.00％,which was significantly lower than 34.00％in the control group(P＜0.01).Conclusion:Bedside ultrasound monitoring GRV and MI can reduce the incidence of feeding-and infection-related complications,and promote recovery of patients.It may be related to antagonism of inflammatory reaction,improvement of immune function and intestinal barrier function,regulation of gastrointestinal hormones and nutritional status.
enteral nutritionbdeside ultrasoundgastric residual volumemotilite indeximmune inflam-matory responsegastrointestinal function
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