| PurposeEvaluate the consistency between syringe suction using the 50ml injector at different positions and ultrasound measurement of gastric residual volume,and explore the exact position which the gastric residual volume was suctioned closest to the volume measured by ultrasound machine.We could provide a reference for accurate assessment of gastric residual volume.Method137 patients with nasogastric tube in department of neurosurgery in the Chinese peopled liberation army 101 hospital from December 2016 to June 2016 were randomly enrolled.We select three different time points:An empty stomach(fasting for more than 8 hours),4 hours after continuous infusion nutrition,4 hours after intermittent feeding.At these time points,the consistency of syringe suction(at left lateral position,supine position,right lateral position)and ultrasound measurement of gastric residual volume were evaluated.Before each measurement,the ultrasonic measurement was performed at the position of the bed raising 45° and right lateral position placing at 45°.Then we suctioned the gastric residual volume using 50ml injector at the left lateral position,supine position,right lateral position.Chose Paired sample t test,Bland-Altman statistical methods and Pearson's correlation analysis to analyze evaluation of consistency between using 50ml syringe suction under different positions and ultrasound measurement for gastric residual volume on three different times.Results1.An empty stomach(fasting for more than 8 hours):Syringe aspiration at left lateral position,supine position,right lateral position and ultrasonic measurement of gastric residual volume were statistically significant(P<0.05).The volume of a syringe suction is 0 ml in the left side position group on an empty stomach.The different data between ultrasound measurement of GRV and the syringe suction of supine position group is 24.31±4.55ml,and the different data between ultrasound measurement of GRV and the syringe suction of the right side position group is 17.700±2.39ml.2.4 hours after continuous infusion nutrition:there was significant difference between using 50ml syringe suction under three different positions and ultrasound measurement for gastric residual volume(P<0.05).Bland-Altman analysis for the measurements showed a good relativity between using 50ml syringe suction under the right side position and ultrasound measurement.Consistency analysis showed that the average difference levels between ultrasound measurement and using 50ml syringe suction were 48.8ml in the left side position group,32.4ml in supine position group and 18.6ml in the right side position group,respectively.Under three different positions the average difference levels were higher than 0 level.Incidences beyond the consistency zone of upper and lower limit in the left side position group were 4.38%?2.92%,in supine position group were 5.12%?2.92%,in the right side position group were 2.19%?1.46%.There was significant difference between three syringe suction groups for gastric residual volume(P<0.05).3.4 hours after intermittent feeding:there was significant difference between using 50ml syringe suction under three different positions and ultrasound measurement for gastric residual volume(P<0.05).Bland-Altman analysis for the measurements showed a good relativity between using 50ml syringe suction under the right side position and ultrasound measurement.Consistency analysis showed that the average difference levels between ultrasound measurement and using 50ml syringe suction were 46.lml in the left side position group,29.2ml in supine position group and 17.3ml in the right side position group,respectively.Under three different positions the average difference levels were higher than 0 level.Incidences beyond the consistency zone of upper and lower limit in the left side position group were 5.12%?0.01%,in supine position group were 3.65%and 3.65%,in the right side position group were 2.19%and 1.46%.There was significant difference between three syringe suction groups for gastric residual volume(P<0.05).4.The values of ultrasound-monitored gastric residuals were compared between 4 hours after continuous nutrient infusion and 4 hours after intermittent bolus injection in three different groups and the t-test was used in syringe-suction gastric residuals:there was a statistically significant difference(P<0.05).Conclusion1.When patients were on an empty stomach(fasting more than 8 hours),there is a high consistency between the syringe suction at three positions and the gastric residual measured by ultrasound.2.Four hours after continuous nutrient infusion,syringe suction at the right lateral position was highly consistent with gastric residual measured by ultrasound results,it is recommended to use a 50 ml syringe to aspirate the gastric residue when the bed is raised 45° to the right.3.Four hours after intermittent feeding,syringe suction at the right lateral position has a high consistency with the ultrasound measurement of gastric residual.It is recommended to use a 50 ml syringe to aspirate the gastric residue at the right lateral position where the bed was raised 45°.4.For patients with normal gastrointestinal function,the gastric residual volume after the intermittent feeding at three positions was less than that of 4 hours after continuous infusion nutrition at three different positions.Intemittent feeding is beneficial to reduce the gastric residual amount in enteral nutrition. |
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