The effect of abdominal massage on enteral nutrition tolerance in patients on mechanical ventilation: A Randomized Controlled Study

Objective: To assess whether abdominal massage impacts enteral feeding tolerance in mechanically ventilated patients.Methods: Patients were randomized to receive standard or intervention care (standard care plus a 15-minute abdominal massage twice daily) for three days. We recorded the vomiting, reflux, gastric retention, aspiration, diarrhea, abdominal distension, gastric residual volume and abdominal circumference from days one to three. A P-value of less than 0.05 was statistically significant. Results: Seventy-four patients (37 per group) were recruited (intervention vs control: age 58.03 +/- 10.44 vs 55.33 +/- 12.45 years; %M: 69.70 % vs 69.70 %). The aspiration, gastric retention and abdominal distension incidence in the intervention group was 3.03 %, 6.06 % and 9.09 %, whereas in the control group it was 24.24 %, 30.30 % and 27.27 % (P <.05). The vomiting, reflux and diarrhea incidence for patients in the intervention group were all 3.03 %, whereas in the control group they were 3.03 %, 9.09 % and 9.09 % (P >.05). From day 1 to day 3, the gastric residual volume decreased from 87.23 +/- 3.29 mL to 72.59 +/- 5.40 mL in the intervention group and increased from 91.94 +/- 3.45 mL to 105.00 +/- 6.94 mL in the control group. Similarly, the abdominal circumference decreased from 84.41 +/- 1.73 cm to 82.44 +/- 1.73 cm in the intervention group and increased from 87.90 +/- 1.60 cm to 88.90 +/- 1.75 cm in the control group. The differences in time, group, and interaction effects between the two groups were statistically significant for abdominal circumference and gastric residual volume (P <.05).Conclusions: Abdominal massage can effectively reduce gastric retention, abdominal distension, aspiration, gastric residual volume and abdominal circumference in mechanically ventilated patients, but not the incidence of vomiting, reflux and diarrhea.