Intestinal Feeding Intolerance And Its Influencing Factors In Patients With Septic Shock

Objective1.To investigate the status of intestinal feeding intolerance in patients with septic shock and provide reference for clinical management.2.To explore the high risk factors of feeding intolerance in patients with septic shock,and to provide theoretical basis for clinical development of response measures.Methods168 patients with septic shock who required enteral feeding and met the exclusion criteria were selected from January 2017 to December 2019 in the emergency ICU,comprehensive ICU,and respiratory ICU of a third-class A general hospital in Zhengzhou City.research analysis.A unified general data questionnaire and enteral nutrition intolerance questionnaire were used for data collection.When the patient data was collected,the two researchers jointly checked the data to ensure the accuracy and completeness of the data collection.Univariate analysis and logistic regression analysis were conducted on the factors causing feeding intolerance in 168 patients with septic shock.Results1.Of the 168 patients with septic shock undergoing enteral feeding,66 patients developed feeding intolerance,that is,the incidence of feeding intolerance in patients with septic shock during enteral nutrition was 39.29%.More patients with septic shock developed feeding intolerance than the first 1 to 4 days of enteral feeding,and the duration lasted for 1 to 3 days.27 patients(40.91%)showed persistent feeding intolerance,and 16 patients(24.24%)showed recurrent intolerance,including 25 cases(37.88%)of diarrhea,22 cases(33.33%)of massive gastric retention,9 cases(13.64%)of bloat-ing/abdominal pain,6 cases(9.09%)of vomiting/reflux,complaining of discomfort in 4 cases(6.06%).2.The feeding intolerance o.f 168 patients in the process of enteral feeding was regarded as the dependent variable,including sex,age,Apache score,type of nutrition preparation,daily dosage of nutrition preparation,tube placement,enteral nutrition time,mechanical ventilation,CRRT,sedative,analgesic,antibiotic,antacid,vasoactive drug,potassium preparation,non steroids 21 factors,such as anti-inflammatory drugs,CVP,dietary fiber,gastric motility drugs,procalcitonin,lactate and C-reactive protein,were analyzed as independent variables.The results showed that apachi score,mechanical ventilation,sedative and analgesic,daily dosage of en preparation,antacids,antibiotics,potassium preparation,dietary fiber and gastric motility drugs added in enteral nutrition,central venous pressure had an effect on feeding-intolerance in patients with septic shock during enteral nutrition period(P<0.05).3.The 10 factors of statistical significance in the single-factor analysis were included as an argument,and Logistic regression analysis was carried out,namely,APACHII score,mechanical ventilation,DAILY dose of EN preparation,analgesic,sedative,acid-suppressor,oral potassium preparation,antibiotic type,abdominal internal pressure,central venous pressure is too-high,dietary fiber and gastric power medicine were added to intestinal nutrition,regression analysis was carried out by the forward-step Wald x2 method,and the regression equation was R2=0.523,?2=64.914,P<0.001,and the regression equation is statistically significant.Logistic multi-factor analysis results:the application of mechanical ventilation,APACHII score,antibiotics,abdominal pressure,high central venous pressure is an independent risk factor that causes infectious shock patients to experience feeding intolerance during intestinal nutrition,giving intestinal nutrition to add dietary fiber and gastric-promoting drugs are protective factors.Conclusion1.The factors affecting intestinal feeding intolerance in patients with infectious shock are complex and diverse,and the incidence of intestinal feeding intolerance is high in patients with infectious shock,and health care workers should closely observe the nutritional status of the intestinal tract in patients with infectious shock and make timely and effective assessment.2.APACHII score,application of mechanical ventilation,application of antibiotics,central venous hypertension are the risk factors for feeding intolerance during intestinal feeding in patients with infectious shock,and the addition of dietary fiber and gastric-promoting drugs to intestinal nutrition is a protective factor.