Objective: Enteral feedimg through nasogastric tube is common in ICU patients, but there is some complications. These complications can be effected enough protein and energy need in ICU patients. As a result, these patients do not reach the targeted calorie. Malnutrition has been reported about 35% in ICU patients. Studies have shown that abdominal massage can be increased the rate of gastric emptying in patients with high gastric residual volume. In this randomized clinical trial study, population consisted of patients admitted to the intensive care unit and enterally fed intermittently via nasogastric tube. The study was conducted with 80 subjects, 40 in the massage group and 40 in the control group. Inclusion criteria included subjects who were being fed intermittently and enterally via a nasogastric tube, age over 18 years, no receive metoclopramide, erythromycin, cisapride, and anticholinergic agents, no receive radiotherapy and abdominal surgery in the previous 6 weeks, and absence of contraindication to abdominal massage.
In the data collection stage, if two times consecutively vomiting or diarrhea was observed in subjects in the massage group, is excluded from the study.
In both control and massage group gastric residual volume has being measured by aspirating with 50 ml syringe before each feeding. Subjects is fed through a nasogastric tube 7 meals in a day, from 6 a.m. untill 12 midnight, in the 30-45 head up position and by gravity via gavage syringe. Abdominal massage is only applied to the massage group subjects for 10 minutes, 3 times daily for 3 consecutive days,30 minutes before feeding at 8:30 a.m., 2:30 p.m., and 8:30 p.m. During massage application, the subject is placed in a supine position with the head-of-bed elevated at 30°–45°. The abdominal massage is applied in a clockwise direction over the abdominal wall, based on four basic strokes are typically used in Swedish massage: stroking, effleurage, kneading, and vibration. The accepted criteria for food tolerance include a GRV less than half of the food amount given in the previous meal and absence of vomiting and diarrhea.