Complications Occurring during Enteral Nutrition Support: A Prospective Study

Cataldi-Betcher, Emma L.; Seltzer, Murray H.; Slocum, Bernadette A.; Jones, Kenneth W.

doi:10.1177/0148607183007006546

Cited by 273 publications

(91 citation statements)

References 48 publications

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“…Discarding gastric aspirate may result in loss of gastric fluids and electrolytes (Cataldi-Betcher et al, 1983), but this hypothesis cannot be verified with our work as we could not identify any differences.…”

Section: Discussioncontrasting

confidence: 62%

To return or to discard? Randomised trial on gastric residual volume management

Juvé‐Udina

Valls-Miró

Carreño-Granero

et al. 2009

Intensive and Critical Care Nursing

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SUMMARYBackground: The control of gastric residual volume (GRV) is a common nursing intervention in intensive care; however the literature shows a wide variation in clinical practice regarding the management of GRV, potentially affecting patients' clinical outcomes.The aim of this study is to determine the effect of returning or discarding GRV, on gastric emptying delays and feeding, electrolyte, and comfort outcomes in critically ill patients.Method: A randomised, prospective, clinical trial design was used to study 125 critically ill patients, assigned to the return or the discard group. Main outcome measure was delayed gastric emptying. Feeding outcomes were determined measuring intolerance indicators, feeding delays and feeding potential complications. Fluid and electrolyte measures included serum potassium, glycaemia control and fluid balance. Discomfort was identified by significant changes in vital signs.Results: Patients in both groups presented similar mean GRV with no significant differences found (p=0,111), but participants in the intervention arm showed a lower incidence and severity of delayed gastric emptying episodes (p=0,001).No significant differences were found for the rest of outcome measurements, except for hyperglycaemia. Conclusions:The results of this study support the recommendation to reintroduce gastric content aspirated to improve GRV management without increasing the risk for potential complications.

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Section: Discussioncontrasting

confidence: 62%

To return or to discard? Randomised trial on gastric residual volume management

Juvé‐Udina

Valls-Miró

Carreño-Granero

et al. 2009

Intensive and Critical Care Nursing

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“…The reported incidence of diarrhea in patients receiving ETF is 2-95% (Cataldi-Betcher et al, 1983;DeMeo et al, 1998). The large variability is due to differences in the patient groups investigated, the method of reporting and, importantly, the definition of diarrhea used.…”

Section: Introductionmentioning

confidence: 99%

Assessment of fecal output in patients receiving enteral tube feeding: validation of a novel chart

2004

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Objective: To develop a practical, valid and reliable chart to assist in the accurate visual characterization of fecal output in patients receiving enteral tube feeding (ETF). Design: A chart incorporating verbal and pictorial descriptors of fecal output was developed. Validity and reliability were assessed by a questionnaire survey of health professionals and a clinical study of patients commencing ETF. Content validity was assessed from the results of the questionnaire, construct validity by contrasting groups analysis, concurrent validity by comparison of the chart with actual fecal weight and inter-rater reliability by independent characterization of the same fecal sample by two nurses. Setting: St George's Hospital, London, UK. Subjects: In all, 35 health professionals completed a questionnaire with respect to the chart. The chart was then used to monitor fecal output in 36 patients commencing ETF for a total of 171 patient-days, during which time nurses used the chart to characterize 269 fecal samples, of which 59 were subsequently weighed. Results: The results of the questionnaire suggested good content validity. The chart demonstrated statistically significant differences in fecal frequency, fecal consistency, fecal score and incidence of diarrhea for contrasting patient groups expected to have different fecal output (Po0.05). The inter-rater reliability was almost perfect for fecal consistency (95% agreement, k ¼ 0.91) and substantial for fecal weight (83%, k ¼ 0.75). In all, 83% of fecal samples were assigned to the correct weight category (k ¼ 0.75). Conclusion:The chart has good content, construct and concurrent validity and inter-rater reliability, and is suitable for both research and clinical use.

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“…[1][2][3][4][5][6][7][8] The incidence of major complications is 8% to 20%. Mechanical complications are difficult to assess clinically.…”

Section: Discussionmentioning

confidence: 99%