Ahmad Shoaib, Le Vu, Kaitha Sindhu, Morton Jordan, Ali Tauseef
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126, USA.
South Med J. 2012 Aug;105(8):394-8. doi: 10.1097/SMJ.0b013e31825d9bef.
To maintain adequate nutrition for patients who are in need, enteral feeding via nasogastric tube (NGT) is necessary. Although the literature suggests the safety of continued NGT feeding at a gastric residual volume of <400 mL, inconsistencies in withholding tube feeding based on residual volume have been observed in clinical practice. We performed a regional survey to determine the range of current practice among nursing staff regarding the decision to withhold NGT feeding based on residual volume and the factors that influence the decision-making process.
A questionnaire was designed to evaluate nursing practice patterns regarding the decision of withholding NGT feeding based on a certain residual volume, which was distributed to the nursing staff at all major hospitals in the Oklahoma City metropolitan area. Statistical analysis was done with the Fisher exact test. All of the statistical tests were carried out at α = 0.05.
A total of 582 nurses completed the survey. Residual volumes (milliliters) resulting in the termination of NGT feeding occurred in 89% of nurses at volumes <300 mL and only 3% of nurses at volumes >400 mL. Three main reasons for nurses to withhold NGT feeding were risk of aspiration (90%), potential feeding intolerance (81%), and risk of regurgitation (67%). Other less common concerns were abdominal distension and abdominal discomfort.
The decision of withholding NGT feeding varied among the nursing staff that were surveyed. A consensus is necessary for the standardization of withholding NGT feeding in clinical practice among nursing staff.
对于有营养需求的患者，经鼻胃管（NGT）进行肠内喂养是必要的。尽管文献表明胃残余量<400 mL时持续经鼻胃管喂养是安全的，但在临床实践中，基于残余量停止管饲喂养的做法并不一致。我们进行了一项区域调查，以确定护理人员目前关于基于残余量停止经鼻胃管喂养的决策范围以及影响决策过程的因素。
设计了一份问卷，以评估基于一定残余量停止经鼻胃管喂养的护理实践模式，并将其分发给俄克拉荷马城大都市区所有主要医院的护理人员。采用Fisher精确检验进行统计分析。所有统计检验均在α = 0.05水平下进行。
共有582名护士完成了调查。胃残余量（毫升）导致经鼻胃管喂养终止的情况，89%的护士在残余量<300 mL时出现，而在残余量>400 mL时只有3%的护士出现。护士停止经鼻胃管喂养的三个主要原因是误吸风险（90%）、潜在的喂养不耐受（81%）和反流风险（67%）。其他不太常见的担忧是腹胀和腹部不适。
在接受调查的护理人员中，停止经鼻胃管喂养的决策各不相同。护理人员在临床实践中对停止经鼻胃管喂养进行标准化达成共识是必要的。
