Study of gastric motility detection-guided enteral nutrition in children with mechanical ventilation after cardiac surgery

Objective To investigate the feasibility of gastric motility detection-guided enteral nutrition in children with mechanical ventilation after cardiac surgery.Methods Ninty-two children who suffered from mechanical ventilation after cardiac surgery between May 2011 to May 2012 in our hospital were randomly set into two groups:①Gastric fluid withdrawing group (n =46):to adjust the therapeutic strategy of enteral nutrition by evaluation of gastric residual volume by withdrawing gastric fluid every four hours;②ultrasound assessment group (n =46):to adjust the therapeutic strategy of enteral nutrition by evaluation of Gastric emptying and gastric motility index.We observed the average time of enteral nutrition up to standard,complication of enteral nutrition including infection,reflux and diarrhea.Additionally,other parameters such as levels of prealbumin and albumin,offline period,ICU time,hospitalization time and mortality were observed.Based on these results,the effect of enteral nutrition was compared between two groups.Results The ultrasound assessment group was associated with decreased average time of enteral nutrition,up to standard [(30.4 ± 10.3)h vs (36.6±9.5)h,P＜0.05] increased everyday calories [(60.3 ± 13.9)kcal/kg vs (42.7 ± 10.8)kcal/kg,P＜0.05],prealbumin:(247.5 ± 65.3)mg/L vs (215.6 ± 45.8)mg/L (P＜0.05) and albumin:(34.7 ±6.2)g/L vs (30.4 ± 4.9)g/L (P＜0.05),decreased infection(6.5％ vs 26.1％),reflux(10.9％ vs 32.6％),offline period (60.7 ± 12.4)h vs (78.5 ± 10.2)h,ICU time (4.4 ± 1.6)d vs (5.4 ± 1.2)d and hospitalization time (11.6 ± 3.2) d vs (13.2 ± 4.2) d.Conclusions The assessment of gastric motility using ultrasound is an effective guidance for application of enteral nutrition in children suffering from mechanical ventilation after cardiac surgery.Furthermore,it is prominent to improve the efficacy of enteral nutrition and to reduce complications in children suffering from mechanical ventilation after cardiac surgery. Key words: Ultrasonography;  Cardiac surgical procedures;  Ventilators mechanical;  Gastric emptying;  Enteral nutrition