Nurse's Role Clinical Trial
Official title:
The Effect of Abdominal Massage on Gastric Problems in Patients With Enteral Nutrition in Pediatric Intensive Care: A Randomized Controlled Study
Many system functions differ in children dependent on mechanical ventilation support and may present with various complications. In the gastrointestinal system, gastric and duodenum-related decreased motility disorders are a very common problem in critically ill patients hospitalized in the intensive care unit, which increases mortality and morbidity. The prevalence of gastric dysmotility in pediatric intensive care is estimated to be 50%. Gastric problems such as vomiting, increase in the amount of gastric residue, decrease in bowel movements, abdominal distension, diarrhea/ constipation, etc. are observed as a result of the dysfunction of the gastrointestinal system. In addition to these problems; there are problems associated with the ventilator such as pneumonia, infection, bacterial growth, and stopping enteral feeding. Malnutrition as a result of stopping feeding prolongs the hospitalization of intensive care patients and affects mortality. Intensive care nurses play a key role in providing nutritional support to patients who receive mechanical ventilation support and whose level of consciousness is reduced. Intensive care nurses have many responsibilities such as timely initiation of nutrition, application of correct nutrition, correct placement of feeding tubes, and prevention of problems that may arise as a result of nutrition. Abdominal massage practice is a therapeutic, independent, and evidence-based nursing intervention. It has been used for many years to increase the motility of the gastrointestinal system and to treat constipation. Inexpensive and easy to apply abdominal massage compared to other methods; It increases intestinal motility, accelerates the mechanical advancement of nutrients in the digestive system, improves the blood flow of the region, and is effective in reducing intra-abdominal pressure. It has been reported in the literature that abdominal massage applied to preterm babies increases nutritional tolerance. Studies on adults have also reported that gastric residue is reduced, less vomiting is experienced, and abdominal distension is less common. However, there is no study examining the effects of abdominal massage in reducing gastrointestinal problems in children hospitalized in pediatric intensive care units and receiving ventilator support. Therefore, the aim of this study is to examine the effect of abdominal massage on gastric problems in children who are fed enterally in the pediatric intensive care unit.
Status | Recruiting |
Enrollment | 40 |
Est. completion date | December 31, 2021 |
Est. primary completion date | December 31, 2021 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 1 Month to 24 Months |
Eligibility | Inclusion Criteria: - The child's family volunteering to the research - The ages of the children participating in the study are between 30 days and 24 months. - At least 48 hours of mechanical ventilation support - Beginning of enteral feeding and at least 24 hours have passed since - Feeding with a nasogastric tube - Very low, low or moderate mortality score according to the PRISM III score - Not having had abdominal surgery Exclusion Criteria: - High or very high mortality score compared to the PRISM III score - Anatomically, the absence of gastrointestinal system integrity Having a gastrostomy or stoma Having a tracheostomy - Inotrope receiving treatment - Hemodynamics is not stable - Intracranial bleeding, increased intracranial pressure, cranial tumor, etc. having a severe neurological problem, such as |
Country | Name | City | State |
---|---|---|---|
Turkey | Bakirkoy Dr. Sadi Konuk Training and Research Hospital | Bakirköy | Istanbul |
Lead Sponsor | Collaborator |
---|---|
Istanbul University-Cerrahpasa |
Turkey,
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* Note: There are 20 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Variation of intra abdominal pressure measurement compared to abdominal massage | Data will be collected in line with the intra-abdominal pressure measurement protocol created by the researcher. Measurements will be made with the help of a bladder catheter that is present in the patient. The measurement will be repeated before and after the massage. | Three days | |
Primary | Variation of gastric residue measurement compared to abdominal massage | The gastric residue will be checked by the nurses with a feeding syringe and recorded on the investigation form. Before each feeding, gastric residue will be checked. Before and after the massage results will be compared. | Three days | |
Primary | Measurement of abdominal circumference in centimeters | The abdominal circumference of the patient is measured with the help of a tape measure. | Three days | |
Primary | Bowel sounds in minutes / numbers | Bowel sounds are listened to with a stethoscope on four quadrants for one minute. | Three days | |
Primary | Presence of abdominal distension | The abdomen of the patient is examined manually and evaluated in terms of distension. | Three days | |
Primary | Presence of defect in terms of days / frequency | It is recorded how many times the patient defecated during the day. | Three days | |
Primary | Presence of vomiting in terms of days / frequency | How many times the patient vomited during the day is recorded. | Three days |
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