Introduction: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. as a result Prolong the time of mechanical ventilation and hospitalization in ICU. Studies have shown that abdominal massage may reduce complications and improve digestive function and can be increased the rate of gastric emptying in patients with high gastric residual volume.
Objective: To evaluate the effect of abdominal massage on gastrointestinal function in patients with endotracheal tube in intensive care units.
Design: This is a randomized clinical trail.
Setting and Conduct: After getting ethical code and coordination with intensive care units, researcher will start the study. convenience sampling will use to collect the eligible subjects then they will allocated to intervention or control group by randomization (using minimization). The subjects will be assess for three days.
Participants: In this study, population consisted of patients admitted to the intensive care unit who has an artificial airway and enterally fed intermittently via nasogastric tube. The study will conduct with 70 subjects, 35 in the massage group and 35 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 prokinetic of medications such as metoclopramide and anticholinergics agents such as atropine; consciousness (GCS) less than 9; no receive radiotherapy and abdominal surgery in the previous 6 weeks; and absence of contraindication to abdominal massage. Exclusion criteria included: subjects who having vomiting; NPO for doing laboratory tests and surgical procedures; incidence diarrhea; discharge from ICU or death less than 3 days; Hyper glycaemia and hypokalemia; , GIl bleeding; patientes be extubated before 3 days; patients who have aspiration Before entering the study; patientes because of severe trauma have is not been able to get on the suitable position for massage; patientes have spinal cord injury; ascites during the study.
Intervention: Abdominal massage is only applied to the massage group. subjects in massage group receive 15 minutes abdominal massage, 2 times daily for 3 consecutive days, 30 minutes before feeding at 8:30 a.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.
Main outcome: Distention, gastric residual volume, defecation frequency, constipation and aspiration will be checked before and after the study.