Moreira Telma V, McQuiggan Margaret
Nutr Clin Pract. 2009 Apr-May;24(2):261-73. doi: 10.1177/0884533609332176.
Critically ill patients may experience delayed gastric emptying. Patients receiving enteral feeding are monitored closely to detect a delay of gastric emptying, assess feeding tolerance, and prevent aspiration pneumonia. The most common practice for assessing gastric emptying is to measure the aspirated gastric residual volume; however, this is an unreliable method that lacks standardization, fails to differentiate normal digestive secretions from enteral formula, and results in unnecessary interruptions of enteral nutrition. The aim of this review is to identify an alternative method to assess gastric emptying, which should be reliable, sensitive, harmless, feasible, and inexpensive. Several techniques are discussed: scintigraphy, paracetamol absorption test, breath tests, refractometry, ultrasound, and gastric impedance monitoring. Refractometry seems to be the most appropriate tool for the regular assessment of enteral nutrition; however, standardization and validation of this method are needed before it can be routinely used to monitor critically ill patients receiving enteral nutrition.
重症患者可能会出现胃排空延迟。接受肠内喂养的患者需密切监测，以检测胃排空延迟情况，评估喂养耐受性，并预防吸入性肺炎。评估胃排空最常用的方法是测量吸出的胃残余量；然而，这是一种不可靠的方法，缺乏标准化，无法区分正常消化分泌物和肠内营养配方，还会导致肠内营养不必要的中断。本综述的目的是确定一种评估胃排空的替代方法，该方法应可靠、灵敏、无害、可行且成本低廉。文中讨论了几种技术：闪烁扫描法、对乙酰氨基酚吸收试验、呼气试验、折射测定法、超声检查和胃阻抗监测。折射测定法似乎是定期评估肠内营养最合适的工具；然而，在将该方法常规用于监测接受肠内营养的重症患者之前，需要对其进行标准化和验证。
