Application of Enteral Nutrition Program in Patients With Intra-abdominal Hypertension Oriented by Intra-abdominal Pressure

In this study, relevant contents of the enteral nutrition nursing programs for severe patients with abdominal pressure were systematically searched, and quality evaluation was carried out based on existing evidence. Based on evidence-based evidence, an enteral nutrition nursing program for patients with abdominal pressure was constructed, to improve the feed tolerance of patients with abdominal pressure, increase nutritional compliance rate, and improve patient prognosis.

Study Overview

• Status: Completed
• Conditions: Intra-Abdominal Hypertension
• Intervention / Treatment: Behavioral: enteral nutrition program for patients with abdominal hypertension guided by abdominal pressure

Detailed Description

Background: Enteral nutrition is the preferred method of artificial nutrition for critically ill patients. Early enteral nutrition within 24 to 48 hours after admission can maintain intestinal mucosal barrier function, increase local blood flow, reduce bacterial migration, and reduce the incidence of intestinal infections. Increased abdominal pressure is considered to be an independent risk factor for feeding intolerance in severe patients. Patients with abdominal pressure are prone to complications such as diarrhea, abdominal distension, vomiting, and even aspiration, which forces the suspension or suspension of enteral nutrition and leads to insufficient nutritional intake in patients. At present, there is evidence that regulating enteral nutrition through monitoring intra-abdominal pressure can effectively reduce the incidence of feeding intolerance in patients. Domestic and foreign scholars have formulated nutrition management programs for patients with intra-abdominal pressure from different aspects, such as monitoring and grading of intra-abdominal pressure, evaluation and management of tolerance, and prevention of complications. However, The standardized enteral nutrition feeding program oriented by the monitoring of intra-abdominal pressure has not yet formed a unified standard.

Objective: This study conducted a quality evaluation based on existing evidence, adopted evidence-based research methods to establish an enteral nutrition program for patients with abdominal hypertension oriented by abdominal pressure, and aimed to improve the feeding tolerance of patients with abdominal hypertension, improve the nutritional compliance rate and improve the prognosis of patients through the implementation of evidence-based practice programs.

• Study Type: Interventional
• Enrollment (Actual): 218
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hangzhou, China, 310000
    • Feng Xiuqin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

1. Inclusion Criteria

   1. 12mmHg≤ intraperitoneal pressure ≤20mmHg (1mmHg=0.133kPa)
   2. ≥18 years of age

   3. Consistent with the indications of early enteral nutrition

      • Patients with nutritional risk, gastrointestinal function, or partial gastrointestinal function and unable to eat through the mouth

        • Stable hemodynamics (MAP > 65mmHg, blood lactic acid < 4mmol/L, and vasoactive drugs in the process of reduction or withdrawal)
   4. Patients or their family members sign the informed consent

2. Exclusion Criteria

   1. Pregnant or lactating female patients
   2. Patients with recent abdominal surgery
   3. Patients with a large number of abdominal effusions;

   4. There are contraindications to enteral nutrition

      • Uncontrolled shock

        • Uncontrolled hypoxemia and acidosis

          • Uncontrolled upper gastrointestinal bleeding

            • GRV > 500mL/ 6h

              • Intestinal ischemia

                • Intestinal obstruction

                  • Abdominal space syndrome (ACS)

                    • High fistula without distal feeding

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: enteral nutrition program by intra-abdominal pressure; enteral nutrition program for patients with intra-abdominal hypertension guided by intra-abdominal pressure	Behavioral: enteral nutrition program for patients with abdominal hypertension guided by abdominal pressure; There are 4 aspects of intra-abdominal pressure monitoring, source control and treatment for the etiology of increased abdominal pressure, enteral nutrition program, enteral nutrition tolerance evaluation and treatment
No Intervention: Routine nursing measures

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of feeding intolerance	Incidence of feeding intolerance: refers to the frequency of new cases of feeding intolerance within 7 days after the initiation of enteral nutrition.	7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The standard rate of feeding	Enteral nutrition feeding standard rate (%)=(actual feeding quantity ÷ target feeding quantity)×100%	7 days

Collaborators and Investigators

• Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2022
• Primary Completion (Actual): October 1, 2022
• Study Completion (Actual): November 1, 2022

Study Registration Dates

• First Submitted: February 8, 2023
• First Submitted That Met QC Criteria: February 8, 2023
• First Posted (Actual): February 17, 2023

Study Record Updates

• Last Update Posted (Estimate): February 23, 2023
• Last Update Submitted That Met QC Criteria: February 22, 2023
• Last Verified: February 1, 2023

More Information

Terms related to this study

• Keywords: Enteral Nutrition; Feeding Intolerance; Intra-Abdominal Hypertention
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Musculoskeletal Diseases; Muscular Diseases; Compartment Syndromes; Hypertension; Intra-Abdominal Hypertension
• Other Study ID Numbers: 2021-0899

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No